Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
The Third Clinical Medical School of Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.
Hernia. 2021 Apr;25(2):375-381. doi: 10.1007/s10029-020-02219-1. Epub 2020 May 25.
It is difficult to manage the full-thickness defect that is created by radical resection of an abdominal wall tumor. This report aimed to review our institutional experience with immediate reconstruction using mesh reinforcement after abdominal wall tumor resection.
We retrospectively examined patients who underwent abdominal wall tumor resection with immediate mesh-reinforced reconstruction between April 2014 and November 2018. The patients' records were reviewed to collect data regarding their demographic characteristics, surgical procedures, and complications.
We identified 30 eligible patients, including 5 who underwent simultaneous resection of affected intra-abdominal organs or tissues. The median size of the resulting abdominal wall defect was 60 cm (interquartile range: 32-127.5 cm) and the median mesh size was 150 cm (interquartile range: 150-225 cm). The median operative time was 85 min (interquartile range: 60-133.8 min), the mean hospital stay was 19.4 ± 9.0 days, and the mean follow-up period was 28.6 ± 16.0 months. The complications included seroma (n = 4), infection (n = 2), massive hematoma (n = 1), and abnormal sensation (n = 3). Tumor recurrence was observed in two patients, and three patients died because of cancer progression. No patient developed a ventral hernia or abdominal bulging.
Immediate mesh-reinforced reconstruction is feasible and effective for patients who require abdominal wall tumor resection.
根治性切除腹壁肿瘤后，全层缺损的处理较为困难。本研究旨在回顾我们机构使用网片加强物进行腹壁肿瘤切除后即刻重建的经验。
我们回顾性分析了 2014 年 4 月至 2018 年 11 月期间接受腹壁肿瘤切除和即刻网片强化重建的患者。回顾患者的记录，收集其人口统计学特征、手术过程和并发症的数据。
我们确定了 30 名符合条件的患者，其中 5 名患者同时切除了受影响的腹腔内器官或组织。腹壁缺损的中位大小为 60cm（四分位间距：32-127.5cm），中位网片大小为 150cm（四分位间距：150-225cm）。中位手术时间为 85min（四分位间距：60-133.8min），平均住院时间为 19.4±9.0d，平均随访时间为 28.6±16.0 个月。并发症包括血清肿（n=4）、感染（n=2）、大量血肿（n=1）和感觉异常（n=3）。2 例患者出现肿瘤复发，3 例患者因癌症进展而死亡。无患者发生腹疝或腹部膨出。
对于需要腹壁肿瘤切除的患者，即刻网片强化重建是可行且有效的。
