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

S D Couto Netto; F Teixeira Jr; C A M Menegozzo; A Albertini; E H Akaishi; E M Utiyama

doi:10.1016/j.ijscr.2017.02.050

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

Int J Surg Case Rep. 2017:33:167-172. doi: 10.1016/j.ijscr.2017.02.050. Epub 2017 Mar 1.

Authors

S D Couto Netto¹, F Teixeira Jr¹, C A M Menegozzo², A Albertini¹, E H Akaishi³, E M Utiyama¹

Affiliations

¹ Departament of Surgery, Division of Surgical Clinic III, Hospital das Clínicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
² Departament of Surgery, Division of Surgical Clinic III, Hospital das Clínicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. Electronic address: carlosmenegozzo@gmail.com.
³ São Paulo State Cancer Institute - ICESP, University of Sao Paulo, Sao Paulo, Brazil.

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.