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

- Desmoid type fibromatosis, although benign and rare tumors, pose significant challenge to surgeons due to their high morbidity and recurrence rate.
- After radical resection, closure of the abdominal wall defect requires the surgeońs expertise and an accurate technique.
- Primary abdominal wall reconstruction using onlay mesh achieves high closure rate and low risk of significant complications.

BackgroundAbdominal 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 MethodsRetrospective analysis of patients who underwent abdominal wall closure after sporadic abdominal desmoid type fibromatosis radical resection from 1982 to 2013.ResultsTwenty-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.ConclusionHigh midline fascial closure rate can be achieved after resection of abdominal wall desmoid tumor using relaxing incisions and mesh, with low complication rate.