Autologous ilium graft combination with Y-shaped titanium plate fixation for chest wall reconstruction after resection of primary sternal tumors—a clinical study from three institutions

Shuonan Xu, Yawei Dou, Guolong Zhao, Jianfei Zhu, Wei Tian, Wei Sun, Zongzhi Liu, Lanjun Zhang, Hongtao Wang


Background: The technique for anterior chest wall reconstruction after resection of primary sternal tumors (PST) still continue to evolve.
Methods: A total of 12 PST patients from three hospitals who underwent en-bloc resection were included in our study. After finishing sternum resection, autologous iliac bone combined with Y-shaped titanium plate were applied to rebuild the anterior chest wall. Postoperative outcomes were analyzed.
Results: There were 10 different types of tumors located in manubrium (6 cases), sternum body (4 cases) and Louis’s angle (2 cases) in our research. For these patients, the median resected tumor size and the area of defect after sternal resection were 279.0 cm3 and 215.0 cm2, respectively. The mean operative time was 299.2±65.2 min and intra-operative blood loss was 431.2±213.0 mL. mean duration of drainage was 9.9±2.6 days. In their perioperative period, significant circulatory and respiratory complications occurred in 8 patients. Postoperative chest X-ray and tridimensional CT images showed autogenous reconstruction of the sternum and titanium in good position. No side effects were observed 6–12 months post reconstructive surgery, but one patient suffered from anchor loss and prosthesis migration. Y-shaped titanium plates from two patients were separately removed at 24 and 26 months when the reconstructive sternum integrated with skeleton anterior chest wall well.
Conclusions: Our study demonstrates the safety and feasibility of this new technique for anterior chest wall reconstruction after sternectomies.