Clinical and surgical outcome following chest wall reconstruction using a novel rigid prosthesis-a single-center experience.

Abstract

<h4>Background</h4>For various reasons, a chest wall resection may be necessary. Large defects in the chest wall and sternum require reconstruction to avoid paradoxical, inadequate breathing, protect underlying structures, and achieve a good functional result. Codubix^®Ribs is a prosthesis made of polyester and polypropylene yarn, which has been recently introduced for reconstruction. Our objective was to evaluate the integrity of the chest wall and the occurrence of pain in patients who underwent resection of the chest wall and/or sternum followed by reconstruction with Codubix^®Ribs.<h4>Methods</h4>We postoperatively collected data from eleven patients (mean age 53 years) who underwent chest wall reconstruction with Codubix^®Ribs between 2019 and 2023. At a prospective visit, pain was assessed using the numeric rating scale (NRS). Functionality was measured by assessing upper extremity mobility (QuickDASH questionnaire; 0 being the best, 100 the worst), clinical examination, and by time resolved dynamic (cine) magnetic resonance imaging (MRI).<h4>Results</h4>Indications for resection were tumors (n=9) and osteomyelitis (n=2) in anterior (n=2), anterolateral (n=7), lateral (n=1), and posterolateral (n=1) locations. The sternum was involved in three patients. Complications included one patient with dislocation due to an initially undersized prosthesis, which was followed by an uneventful reoperation. Functional assessment was performed on nine patients at a median follow-up time of 11 (5.75, 49.5) months. The mean NRS pain score was 1.7±2.2, and the median QuickDASH score was of 6.8. The chest wall was stable in all patients. Dynamic MRI showed symmetric chest wall movement in all but two patients, without observation of paradoxical motion.<h4>Conclusions</h4>We observed excellent functional results using Codubix^®Ribs for chest wall reconstruction, indicating high stability and low complication rates. However, further studies involving a greater number of patients are required to confirm our initial findings.