Resection to restoration: Assessing the synergy of polypropylene mesh (Marlex®) combined with methyl-methacrylate and latissimus dorsi flap for primary chest wall sarcomas.

BACKGROUND: Chest-wall sarcomas are treated with extensive resections and complex defect reconstruction to restore chest-wall integrity. It is a difficult surgical procedure that incorporates a multidisciplinary approach for the best outcome, preventing paradoxical chest movement issues and reducing complications. OBJECTIVE: We aimed to describe our experience of chest-wall reconstruction using polypropylene mesh (Marlex® Mesh) combined with methyl-methacrylate and soft-tissue coverage with a latissimus dorsi flap following sarcoma resection. PATIENTS AND METHODS: Among the 53 patients treated for primary chest-wall sarcomas at the European Institute of Oncology (IEO) in Milan, Italy, from 1998 to 2020, 14 cases underwent chest-wall resection and reconstruction using polypropylene mesh, methyl-methacrylate and the latissimus dorsi flap. Patients with locally advanced breast cancers, locally advanced lung cancers, squamous cell carcinomas, and other secondary chest-wall malignancies were excluded from the study, as were the patients with different types of chest-wall reconstruction. RESULTS: In this study, 14 patients (6 men and 8 women) with various primary chest-wall sarcomas were enrolled. On an average, 2 ribs (range: 1-5) were removed during the surgeries, and the chest-wall defects ranged from 20 to 150 cm2 with an average size of 73 cm2. The mean follow-up period for these patients was approximately 63.80 months CONCLUSION: The combination of Marlex® mesh filled with methyl-methacrylate and covered using latissimus dorsi myocutaneous flap provides safe, low-cost and effective single-stage chest-wall reconstruction after surgery for primary sarcomas.

Online patient education in body contouring: A comparison between Google and ChatGPT.

Appropriate patient education and preparation prior to surgery represent a fundamental step in managing expectations, avoiding unnecessary encounters and eventually achieving optimal outcomes. Thus, the objective of this study is to evaluate ChatGPT's potential as a viable source for patient education by comparing its responses and provided references to frequently asked questions on body contouring, with Google's. A Google search was conducted on July 15th, 2023, using the search term "body contouring surgery". The first 15 questions under the "People also ask" section and answers provided by Google were recorded. The 15 questions were then asked to ChatGPT-3.5. Four plastic surgeons evaluated the answers from 1 to 5 according to the Global Quality Scale. The mean score for responses given by Google was 2.55 ± 1.29, indicating poor quality but some information present, of very limited use to patients. The mean score for responses produced by ChatGPT was 4.38 ± 0.67, suggesting that the content was of good quality, useful to patients, and encompassed the most important topics. The difference was statistically significant (p = 0.001). Deficiencies in providing references represent one of the most evident weaknesses of ChatGPT. However, ChatGPT did not appear to spread misinformation, and the content of the generated responses was deemed of good quality and useful to patients. The integration of AI technology as a source for patient education has the potential to optimize patient queries on body contouring questions.