Excision of giant desmoid in the abdominal wall, method of abdominal wall reconstruction, and follow-up of long-termed effect / 中华外科杂志

ABSTRACT

Objective@#To explore the ideal procedure of excision and repair for giant desmoid in the abdominal wall and long-termed follow-up results.@*Methods@#Clinical and follow-up data of 24 patients with giant desmoid in the abdominal wall underwent radical removal and immediate abdominal wall reconstruction in Diagnostic and Therapeutic Center of Hernia and Abdominal Wall Diseases, First Affiliated Hospital of People′s Liberation Army General Hospital from October 2006 to October 2016 were analyzed retrospectively. Twenty-one female patients with the mean age of 34.6 years and 3 male patients with the mean age of 42.6 years were recruited. The minimal diameter of these tumors was 15 cm, and the maximal diameter was from xiphoid bone to pubic symphysis.@*Results@#All of desmoids were removed radically and proved by the rapid pathologic examination. The size of abdominal wall defect after desmoids removal were 483 (21 cm×23 cm) to 2 100 cm2 (35 cm×60 cm), averaged 945 cm2 (27 cm×35 cm). All of defects were repaired with compound synthetic prosthesis using bridging procedure. Twenty-one patients were recovered smoothly and got primary wound healing. Three patients had prosthesis infected during 1 month postoperatively and 1 patient recovered with conservative therapy, the other 2 patients underwent infected prosthesis removal at 2 weeks and 3 months postoperatively, respectively. Twenty-two patients were followed up with the period of 12 to 121 months and the median period was 63 months. No marginal neoplasm recurrence, incisional hernia, and abdominal wall bulge happened. Eight patients developped fresh desmoids in the abdominal cavity or in the back. Two patients died because of intestinal obstruction due to desmoid infiltration, and the other 6 patients still survived along with stable desmoids.@*Conclusions@#Radical removal for patients with giant desmoid in the abdominal wall is an ideal therapeutic method, and compound synthetic patch can be used to repair huge abdominal wall defect, even the defect compromised all of abdominal wall. The long-termed follow-up results showed these procedures had not put bad influence on the quality of patients′ life.