[Reconstruction of the dysfunctional thoracic cage after removal of the sternum and ribs].

Indications for sternectomy and chest wall resection are considered very carefully due to risk of disturbances in respiratory mechanics. It was assumed that the major respiratory component abnormality after sternectomy and chest wall resection is the excessive mobility of rib stumps left in situ, whereas, the chest defect itself is of lesser importance. 5 patients with sternal tumour and 56 patients with lung cancer were operated and the chest wall resection was performed. In reconstructing the chest wall, the greatest emphasis was laid on rib stump stabilisation. This was carried out by attaching the rib stumps to each other using single sutures. Thanks to this, the rib stumps formed a rigid ring around the defect. Especially, a case of complete sternectomy, in which stabilisation required the fixation of large number of rib stumps, indicates the correctness of this hypothesis.