Clinical and Experimental Gastroenterology (Jul 2020)

Feasibility of the Reconstruction with Fascia Lata Patch on the Abdominal Wall Defect After Resection of the Abdominal Desmoid Tumor

  • Goto A,
  • Matsuhashi N,
  • Takahashi T,
  • Tanahashi T,
  • Matsui S,
  • Imai H,
  • Tanaka Y,
  • Yamaguchi K,
  • Yoshida K

Journal volume & issue
Vol. Volume 13
pp. 249 – 254

Abstract

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Ayana Goto, Nobuhisa Matsuhashi, Takao Takahashi, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Kazuya Yamaguchi, Kazuhiro Yoshida Department of Surgical Oncology, Gifu University School of Medicine, Gifu City 501-1194, JapanCorrespondence: Nobuhisa MatsuhashiDepartment of Surgical Oncology, Gifu University School of Medicine, 1-1 Yanagido, Gifu City 501-1194, JapanTel +81-58-230-6233Fax +81-58-230-1074Email [email protected]: The abdominal desmoid tumor shows invasive development and high local recurrence rate. The primary treatment method is complete removal of the tumor because of the high recurrence rate; however, the problem for the surgeon is the reconstruction of the abdominal wall after resection of the abdominal desmoid tumor.Case Presentation: A 63-year-old man underwent open drainage and ileostomy for the perforation of ileocecal tumor. After 3 months, he underwent right hemicolectomy and ileostomy closure. Pathological examination revealed no malignancy, and the ileocecal tumor showed the presence of abscess. He noticed a palpable mass in the left abdomen. Enhanced abdominal computed tomography (CT) revealed a large abdominal incisional hernia and an enhanced mass of 40 mm in the left rectus muscle. Needle biopsy was performed and the diagnosis was desmoid tumor. He underwent resection of the desmoid tumor and repair of hernia. We performed wide local resection, with a 2-cm surgical margin. The hernia was repaired by simple closure, and the defect in the left abdomen was repaired with reconstruction using the fascia lata patch through plastic surgery.Conclusion: We encountered a case of abdominal wall desmoid tumor combined with a large abdominal incisional hernia. We selected the use of autologous fascia based on the risk of recurrence. The patient has not shown recurrence of incisional hernia or desmoid tumor 22 months after surgery. The use of fascia lata patch can be considered as a satisfactory alternative for such reconstruction cases.Keywords: abdominal desmoid tumor, incisional hernia, abdominal wall reconstruction, autologous fascia

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