I tumori della parete toracica. Considerazioni cliniche su 70 casi operati

Background. Thoracic neoplasms pose peculiar diagnostic and therapeutic problems. The study is aimed at evaluating the good quality of the diagnostic instrumental proceedings and at analyzing the efficacy of a particular reconstructive surgical procedure. Methods. The study includes 70 cases of thoracic neoplasms diagnosed by CT, bone scan, and MRT (46 cases), histologically defined and surgically treated. Benign neoplasms were 13% of the cases and malignant neoplasms 87% of the cases with a prevalence of bone sarcomas (53%) and soft tissue sarcomas (34%). In 15 cases demolition of the thoracic wall was less than 10 cm, in 33 cases more than 10 cm, while in 12 cases it was associated to sternectomy. In 26 cases a particular surgical procedure with metallic plates to avoid paradox respiration was carried out. Results. Differential diagnosis between benign and malignant neoplasms was defined in 53% of the cases. Dimensions and margins are underestimated by CT in 62% of cases and by MRI in 34. There was no mortality, morbidity was present in 14% of the cases. Of the 26 cases treated with a reinforced reconstructive surgical procedure immediate removal of intubation was possible in 10, postponed within 24 hours in 16, and prolonged in 1 case. After surgery deficit of pulmonary volume was less than 10%. Conclusions. Thoracic neoplasms can be treated surgically with good results also after wide excision. A reinforced reconstructive surgical procedure made it possible to avoid deficit of respiratory volume.