Five-Year Experience with Titanium Mesh for Rigid Chest Wall Reconstruction

Objective:To characterize the performance of titanium mesh (TM) (off-label) for rigid chest wall reconstruction from a single institution over five years. Methods:From 1/1/2019 to 5/15/2023, 22 patients, median age 61, underwent chest wall resection with TM reconstruction at Cleveland Clinic.Indications included sarcoma (15), breast cancer (2), lung cancer (2), chondroblastoma (1), and benign neoplasm (2).Patients were followed every six months with Computed Tomography (CT) scans for cancer recurrence.Continuous variables are summarized as median [25 th , 75 th percentile].Categorical variables are summarized using frequencies and percentages.Time to mesh fracture was assessed nonparametrically using Kaplan-Meier analysis. Results :Of the 22 patients and 21,870 patient days of TM implantation, 21 (95%) had an R0 resection.Mean area of mesh coverage was 108 cm 2 [IQR 97-180].There were no respiratory complications or mesh failure post-operatively.Of the 3 (13.6%)instances of reoperations, two were for delayed regional infection (7 and 12 months postoperatively) requiring localized mesh removal and the third was for local cancer recurrence.Fifteen implants developed visible fractures on imaging at a median time of 9 months from implantation.There were no adverse sequelae including migration/erosion or clinical decline in respiratory function.