Flexible chest wall reconstruction with Gore-tex or dual prolene mesh; a reliable approach

<bold>Introduction:</bold> Chest wall resection and reconstruction is a challenging procedure requiring a multidisciplinary approach. It aims to restore chest wall rigidity, preserve pulmonary mechanics and minimize thoracic deformity. Aim: To study clinical outcomes and assess pain after flexible chest wall resection and reconstruction. <bold>Materials & methods:</bold> Retrospective study of patients who underwent chest wall resection and reconstruction with flexible approach in our centre (2013-2023). <bold>Results:</bold> Flexible chest wall reconstruction is defined as the surgical placement of a Gore-tex/prolene dual mesh fixed on the adjusting ribs and extending between the lung and the muscles. Following multidisciplinary team discussion 48 highly selected cases (age range 5-80) underwent chest wall resection and reconstruction. Mean hospital stay was 10 days(range 5-15). Thoracoscopic visualization preceded in 25/48 cases to allow for better orientation prior to mesh placement. Complex procedures requiring synchronous lung resection 15/45(11 lobectomies, 4 wedges). Mean duration of surgery was 120 mins.ITU hospital stay was in 4/45 (flail chest). 6/45 patients presented retention of secretions requiring mini trach. Mortality and disease recurrence was 0% with a follow up range between 0.5- 10years. Post op pain in first 24h was rated as 2/5 (Likert scale) with PCA (patient controlled analgesia). Return to baseline daily activities was within 30 days (median). <bold>Conclusions:</bold> Flexible chest wall resection and reconstruction present satisfactory clinical outcomes and low levels of post operative pain and allow for early return to baseline daily activities.