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腹壁硬纤维瘤。一种新的重建方法。

Abdominal desmoid tumors. A new reconstructive approach.

作者信息

Abbonante Francesco, Ribuffo Diego, Vitagliano Tiziana, Fiorillo Maria Antonia, Ciriaco Antonio Greto, Conversi Andrea, Greco Manfredi

出版信息

Ann Ital Chir. 2015 Jan-Feb;86(1):78-84.

Abstract

INTRODUCTION

Desmoid tumors are rare soft tissue tumors derived from musculoaponeurotic structures of the abdominal wall musculature. Although they are considered benign tumors because they don't metastasize to other parts of the body, they are clinically considered as malignant for their high tendency on infiltrative growth with local invasion and trend to recurrence after local excision. Several reconstructive techniques are proposed in the literature.

METHODS

Nine female patients with abdominal desmoid tumors underwent the removal of a mass of tissue running from the skin to peritoneum near the tumor with a safety margin in macroscopically normal tissue at least of 5 centimeters from the edge of the tumor. After wide excision, a polypropylene mesh was placed in the rear muscular pocket without anchoring suture (sliding mesh sutureless hernioplasty)

RESULTS

No patients had perioperative complications or abdominal wall weakness or an incisional hernia in the following 5 years.

CONCLUSIONS

We consider this technique of abdominal wall reconstruction after desmoid tumor removal a simple procedure that reduces relapsing events and recurrences of abdominal hernia, reducing tension and pain caused by the traditional suture repair technique.

LEVEL OF EVIDENCE

IV.

摘要

引言

硬纤维瘤是一种罕见的软组织肿瘤,起源于腹壁肌肉组织的肌筋膜结构。尽管它们被认为是良性肿瘤,因为它们不会转移到身体的其他部位,但由于其浸润性生长、局部侵袭的高倾向性以及局部切除后复发的趋势,临床上被视为恶性肿瘤。文献中提出了几种重建技术。

方法

9例患有腹部硬纤维瘤的女性患者接受了手术,切除了从皮肤到肿瘤附近腹膜的一大块组织,在肉眼可见正常的组织中距肿瘤边缘至少5厘米处保留安全切缘。广泛切除后,将聚丙烯网片置于后方肌肉袋中,不进行固定缝合(滑动网片无张力疝修补术)。

结果

在接下来的5年中,没有患者出现围手术期并发症、腹壁无力或切口疝。

结论

我们认为这种硬纤维瘤切除术后腹壁重建技术是一种简单的手术方法,可减少腹壁疝的复发事件和复发率,减轻传统缝合修复技术引起的张力和疼痛。

证据等级

IV级。

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