Chest Wall Reconstruction Cohort

NCT07338006 | Recruiting

• 1 other identifier: IRB/2025/1719/SIMS
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Chest wall reconstruction following tumor or infection-related resections remains a challenging aspect of thoracic surgery, requiring restoration of structural stability and preservation of respiratory mechanics. While polymethyl methacrylate (PMMA) bone cement has long been used for rigid reconstruction, its limitations-including high cost, rigidity, infection risk, and interference with normal respiratory motion-pose challenges in resource-constrained settings. Twisted stainless steel wires offer a low-cost, flexible alternative that allows dynamic chest wall movement and easier adaptability in low- and middle-income countries such as Pakistan. To compare postoperative outcomes, complications, and cost-effectiveness of chest wall reconstruction using twisted stainless steel wires versus PMMA bone cement over a two-year period (January 2025 - December 2026). This prospective cohort study was conducted in the Department of Thoracic Surgery, Services Hospital, Lahore, a high-volume tertiary care and referral center. Patients undergoing chest wall reconstruction following resection for tumors, infections, or trauma were enrolled and divided into two groups based on the reconstruction technique used: Group A (twisted steel wires) and Group B (PMMA bone cement). Parameters assessed included postoperative pain (VAS scores), respiratory function, chest wall stability, complications (infection, wound dehiscence, prosthesis exposure), duration of hospital stay, readmission rate, and cost of reconstruction. Data were analyzed to compare clinical and functional outcomes between both cohorts.

Conditions

Chest Wall Tumor; Reconstructive Surgical Procedure; Malignancy

Keywords

Chest wall reconstruction; Bone cement; Stainless steel wire; Thoracic surgery; Postoperative pain; Functional outcomes

Outcome Measures

Primary Outcomes (1)

• Postoperative Pain Assessment:

  Postoperative analgesia followed a standardized multimodal protocol of intravenous paracetamol and NSAIDs unless contraindicated, supplemented with intravenous morphine (0.05-0.1 mg/kg) as required. Thoracic epidural or paravertebral blockade was used selectively based on resection extent or anesthetist preference. Rescue analgesia was administered when VAS pain scores were ≥4 at rest or ≥5 during movement.

  24 hours, 48 hours and 7 days post-operatively

Secondary Outcomes (1)

• Chest Wall Movement

  1 month and 3 months post-operatively

Study Arms (2)

Bone cement Arm

ACTIVE COMPARATOR

This arm included patients that underwent chest wall reconstruction using bone cement

Procedure: chest wall reconstruction

Steel wire arm

EXPERIMENTAL

This arm included patients that underwent chest wall reconstruction with steel wires

Procedure: Chest wall reconstruction

Interventions

Chest wall reconstruction PROCEDURE

Chest wall reconstruction was performed using PMMA bone cement molded intraoperatively over a polypropylene mesh to form a rigid prosthesis. The construct was fixed to the adjacent ribs with nonabsorbable sutures or wires.

Bone cement Arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients aged ≥18 years undergoing partial or full-thickness chest wall resection.
• Defects requiring rigid or semi-rigid reconstruction involving two or more ribs or the sternum.

You may not qualify if:

• Patients with small defects managed by primary closure or soft tissue-only reconstruction.
• Patients with concurrent major intrathoracic resections (e.g., pneumonectomy) may confound postoperative respiratory assessment.
• Recurrent disease requiring revision reconstruction.
• Patients unwilling or unable to provide consent or comply with follow-up.

Sponsors & Collaborators

• University of Health Sciences Lahore: lead

Study Sites (1)

Services Hospital, Lahore

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

MeSH Terms

Conditions

Neoplasms; Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Central Study Contacts

Muhammad Shoaib Nabi, FCPS

CONTACT

+92 3214347410; zeeshan.sarwar195@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: January 3, 2026
• First Posted: January 13, 2026
• Study Start: January 1, 2021
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): March 31, 2027
• Last Updated: January 13, 2026

Record last verified: 2026-01

Locations

PA (1)