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. 2017:33:167-172.
doi: 10.1016/j.ijscr.2017.02.050. Epub 2017 Mar 1.

Abdominal wall reconstruction after desmoid type fibromatosis radical resection: Case series from a single institution and review of the literature

S D Couto Netto  1 , F Teixeira Jr  1 , C A M Menegozzo  2 , A Albertini  1 , E H Akaishi  3 , E M Utiyama  1
Affiliations

Abdominal wall reconstruction after desmoid type fibromatosis radical resection: Case series from a single institution and review of the literature

S D Couto Netto et al. Int J Surg Case Rep. 2017.

Abstract

Background: Abdominal wall desmoid type fibromatosis management has been changing over recent years, from an aggressive approach towards a more conservative one. When radical resection is indicated, the surgical team faces the challenge of abdominal wall reconstruction, for which optimal technique is still debated. The present study reports the experience from a single center with abdominal closures after desmoid type fibromatosis resection.

Material and methods: Retrospective analysis of patients who underwent abdominal wall closure after sporadic abdominal desmoid type fibromatosis radical resection from 1982 to 2013.

Results: Twenty-seven patients were included, mean tumor diameter was 10 + 5.3 cm, and the main choice of abdominal wall reconstruction was midline closure with anterior rectus sheath relaxing incisions and polypropylene onlay mesh (74% of the cases). Only 7% of the cases required more complex procedures for skin closure. Mean follow-up was 5 years and 89% remained disease-free. No grade 4 or 5 complications were observed.

Conclusion: High midline fascial closure rate can be achieved after resection of abdominal wall desmoid tumor using relaxing incisions and mesh, with low complication rate.

Keywords: Abdominal wall reconstruction; Case series; Desmoid resection; Desmoid type fibromatosis; Surgical technique.

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Figures

Fig. 1
Fig. 1
Magnetic Resonance in a pregnant woman revealing abdominal wall desmoid tumor.
Fig. 2
Fig. 2
Preoperative planning of skin resection.
Fig. 3
Fig. 3
Surgical incision showing pregnant uterus. The peritoneal surface protects bowel loops from polypropylene mesh repair.
Fig. 4
Fig. 4
Large abdominal desmoid tumor specimen resected.
Fig. 5
Fig. 5
Surgical technique applied for the abdominal wall reconstruction after desmoid type fibromatosis resection (n = 27).
Fig. 6
Fig. 6
Relaxing Gibson incisions on the anterior sheath of the rectus muscle. This technique was used to facilitate primary fascial closure.
Fig. 7
Fig. 7
Abdominal wall closure using inlay mesh technique according to prosthetic material.
Fig. 8
Fig. 8
Primary skin closure after desmoid tumor resection.
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