• Clinics · Jan 2024

    Predictors of postoperative complications after sternectomy on oncologic patients.

    • João Paulo Cassiano de Macedo, Pedro Henrique Xavier Nabuco-de-Araujo, Benoit Jacques Bibas, José Ribas M de Campos, Paulo M Pêgo-Fernandes, and Ricardo M Terra.
    • Thoracic Surgery Department, Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil. Electronic address: joaozin650@gmail.com.
    • Clinics (Sao Paulo). 2024 Jan 1; 79: 100468100468.

    BackgroundChest wall tumors are uncommon. The surgical objective is local disease control and the relief of symptoms. Due to the heterogeneity of cases, the great variety of reconstructions, size of resection, and clinical and surgical outcomes are still uncertain.MethodsPatients were submitted to sternectomies for tumors between 1997 and 2019. Oncological, and surgical characteristics were taken into consideration. The outcomes were related to the size of resection and classified into local and systemic complications. The authors used univariate and multivariate analyses to determine predictors of complications. Survival analysis and Kaplan-Meier curves were obtained.ResultsThirty resections were performed due to metastatic disease. Partial sternectomy was accomplished in 48.8 %, followed by subtotal in 40 %. Primary closure using Pectoralis major was performed in 48.8 %, and Latissimus dorsi in 35.5 %. Polypropylene mesh was used in 86.6 % of reconstructions. The prosthesis removal was necessary in 6.66 %. Respiratory failure was evidenced in 6.66 %. The resection area was a predictor of local and systemic complications (p = 0.0029; p = 0.0004 respectively) in univariate analysis. However, the size of resection was the only predictor of systemic complications regarding multivariate analysis (p = 0.014, 95 % CI 1.00‒1.07).ConclusionThe size of the resection was related to systemic complications, and the mesh reconstruction resulted in a low percentage of prosthesis removal and respiratory failure. This suggests a high resistance to local issues and a low respiratory failure rate.Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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