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What Is Chest Wall Resection?

Chest wall resection is surgery that removes part of the ribs, sternum, muscles, or other tissues forming the chest wall. It is most commonly performed for primary or metastatic chest-wall tumors but can also be required for infection, radiation injury, or selected traumatic damage. The operation can be partial thickness or full thickness depending on how deeply the disease extends. Large defects are often reconstructed to protect the lungs and heart, restore chest stability, and preserve breathing mechanics.

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What Is Chest Wall Resection?

Chest wall resection is surgery that removes part of the ribs, sternum, muscles, or other tissues forming the chest wall. It is most commonly performed for primary or metastatic chest-wall tumors but can also be required for infection, radiation injury, or selected traumatic damage. The operation can be partial thickness or full thickness depending on how deeply the disease extends. Large defects are often reconstructed to protect the lungs and heart, restore chest stability, and preserve breathing mechanics.

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Why Is Chest Wall Resection Performed?

The procedure is performed when diseased chest-wall tissue must be removed to obtain tumor-free margins, control infection, or treat severe structural damage. Primary bone or soft-tissue sarcomas, metastatic tumors, locally invasive lung or breast cancers, and recurrent malignancies can all require chest-wall resection. Surgical planning considers the number and location of ribs involved, proximity to the sternum or spine, need for lung resection, previous radiation, and whether the defect will require rigid or soft-tissue reconstruction. Multidisciplinary planning is often needed when thoracic, oncologic, plastic, or orthopedic expertise must be combined.

How Is Chest Wall Resection Performed?

The surgeon removes the involved ribs, sternum, muscle, or soft tissue with a planned margin around the disease. When a tumor also invades the lung, diaphragm, pericardium, or other structures, those tissues can be resected during the same operation. Small defects can sometimes be closed directly, while larger defects can require synthetic mesh, rigid plates or prosthetic material, biological grafts, or muscle and soft-tissue flaps. Reconstruction is tailored to maintain chest-wall stability, protect internal organs, and obtain durable soft-tissue coverage.

What Is Recovery Like After Chest Wall Resection?

Recovery depends strongly on how much chest wall is removed and whether lung or other organ resection is performed at the same time. Pain control and respiratory therapy are major priorities because discomfort can limit deep breathing and increase the risk of pneumonia or atelectasis. Patients gradually resume walking and upper-body movement while drains, wounds, and any reconstructive material are monitored. Recovery can be prolonged after large resections or complex flap reconstruction.

What Are the Risks and Complications?

Complications can include bleeding, infection, pneumonia, respiratory failure, wound breakdown, prolonged air leak, and blood clots. Larger defects and combined lung resection increase the risk of postoperative respiratory problems. Prosthetic reconstruction can become infected, shift, fracture, or require removal, while soft-tissue flaps can develop partial or complete necrosis. Published reviews report substantial overall morbidity after complex chest-wall resection, particularly when defects are large or additional thoracic surgery is required.

Frequently Asked Questions About Chest Wall Resection

Are ribs removed during chest wall resection?

Often, yes. One or more ribs can be removed when they are involved by tumor, infection, or another condition requiring full-thickness chest-wall resection.

Does the chest wall always need reconstruction?

No. Small, well-supported defects can sometimes be closed without rigid reconstruction, while larger or strategically located defects often require mesh, plates, grafts, or flaps.

Can lung tissue be removed during the same operation?

Yes. If a tumor extends from the chest wall into the lung, an en bloc pulmonary resection can be performed with the affected chest-wall segment.

What are common complications after chest wall resection?

Respiratory and surgical-site complications are among the most common, including pneumonia, respiratory failure, wound infection, and prosthetic or flap problems.

References

Chest Wall Resection and Reconstruction Following Cancer. PubMed. https://pubmed.ncbi.nlm.nih.gov/41440235/. Date Accessed September 11, 2026.

Chest Wall Resection and Reconstruction: Management of Complications. PubMed. https://pubmed.ncbi.nlm.nih.gov/26515951/. Date Accessed September 11, 2026.

Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience. PubMed. https://pubmed.ncbi.nlm.nih.gov/36233384/. Date Accessed September 11, 2026.

Materials and techniques in chest wall reconstruction: a review. PubMed. https://pubmed.ncbi.nlm.nih.gov/29078657/. Date Accessed September 11, 2026.

Reconstruction of the Chest Wall in Primary and Secondary Tumors: A Systematic Review and Meta-Analysis Comparing Rigid Versus Flexible Materials. PubMed. https://pubmed.ncbi.nlm.nih.gov/40415155/. Date Accessed September 11, 2026.