Abdominal Wall Reconstruction Following Excision of Abdominal Wall Desmoid Tumours

Abstract

Background: Although lacking metastatic potential, abdominal wall desmoid tumours can grow to large sizes and destruct the surrounding structures. Patients and methods: The current study is a prospective study including 17 patients with abdominal wall desmoid tumours conducted during the period from April 2011 till September 2014 in Ain Shams University and Dar Al-Hekma Hospitals. The patients were treated by radical resection of their tumour followed by immediate reconstruction of the abdominal wall by double face proceed mesh after confirmation of negative resection margins by frozen section technique. Results: All tumours were resected with a safety margin of at least 1 cm as proved by frozen section except for one tumour (5.88%). The mean operative time was 116.18 ±12.61 min (range 95-140 min). The mean amount of intraoperative blood loss was 511.33 ±166.56 mL (range 220-800 mL). There was no intraoperative vascular or organ injury and no postoperative abdominal hypertension. The mean visual analogue scale was 3.29 ±1.05 (range 2-5). The mean hospital stay was 3.35 ±1.11 days (range 2-5 days). Postoperative complications were mild and resolved conservatively including wound seroma in 2 patients (11.76%) and superficial wound infection in 1 patients (5.88%). There was no tumour recurrence or incisional hernia during the follow-up period. Hypertrophic scars occurred in 2 patients (11.76%) and improved with local 2 cortisone and fractional Co laser. Conclusion: Radical resection of abdominal wall desmoid tumours with frozen section confirmation of free margins followed by abdominal wall reconstruction by double face proceed mesh offers the best option for treating such tumours.