Surgical management of a giant abdominal wall desmoid tumour

2021 ◽  
Vol 14 (9) ◽  
pp. e244361
Author(s):  
Nandesh Patel ◽  
Ralitsa Slivkova ◽  
Sunil James ◽  
Max Almond
Keyword(s):  
Abdominal Wall ◽  
Soft Tissues ◽  
Abdominal Wall Defect ◽  
Treatment Strategies ◽  
Desmoid Tumour ◽  
Desmoid Tumours ◽  
Surgical Debulking ◽  
Abdominal Mri ◽  
Mri Scans ◽  
Anterolateral Thigh Flaps

Desmoid tumours are clonal fibroblastic proliferations in soft tissues, characterised by infiltrative growth and local recurrence, but not metastasis. Various treatment strategies for desmoid tumours exist, varying from observation, medical and systemic therapy to radiotherapy and surgery. A 25-year-old woman with a background of familial adenomatous polyposis was referred with an enlarging abdominal desmoid tumour measuring 40×40×40 cm despite repeated radiofrequency ablation, surgical debulking and hormone therapy. The patient had a two-stage operation. The first stage involved excision of the desmoid tumour with full-thickness abdominal wall. The abdominal wall was not closed, and a topical negative pressure seal was applied. After 2 days, she underwent the second stage: reconstruction of the abdominal wall defect with a large porcine mesh which was covered with anterolateral thigh flaps. Postoperative complications included ileus and a fall which required further surgery. The patient was discharged 1 month after the first operation. Abdominal MRI scans were performed at 3 and 7 months postdischarge and showed no recurrence of diseaseBackground

Effect of varying the crosslinking degree of a pericardial implant with oligourethane on the repair of a rat full-thickness abdominal wall defect

2018 ◽  
Vol 33 (7) ◽  
pp. 903-914
Author(s):  
Aarón de Jesus Palacios-Rodríguez ◽  
Mauricio Flores-Moreno ◽  
Laura Edith Castellano ◽  
Ramón Carriles ◽  
Iraís Quintero-Ortega ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Soft Tissues ◽  
Second Harmonic ◽  
Abdominal Wall Defect ◽  
Collagen Fibers ◽  
Full Thickness ◽  
Crosslinking Degree ◽  
Wall Defect ◽  
Crosslinking Process

The stability and bioactivity of biologic implants rely mainly on the control of the crosslinking process of collagen. However, the most common methods have no control on the crosslinking degree producing it excessively. This study outlines the role of crosslinking of collagen-based implants with oligourethane on the host response following reconstruction of a rat full-thickness abdominal wall defect. We decellularized and crosslinked bovine pericardial tissue to achieve two crosslinking degrees. For the decellularized implants, named as non-crosslinked (N-CL), the collagen-amines were 0.42 ± 0.02 mmol/mg. Crosslinking by the oligourethane reduced the primary amine concentration to 0.28 ± 0.01 and 0.19 ± 0.01 mmol/mg; these values were classified as low (∼30%, L-CL) and medium crosslinking (∼50%, M-CL), respectively. By imaging the implants using second harmonic generation microscopy, we observed undulated bundles of collagen fibers organized in multi-directed layers localized in N-CL and L-CL samples. Post-implantation, a negligible change in the organization of collagen fibers in the crosslinked implants was observed, suggesting that the in vivo biodegradation was delayed. An enlargement of the implant area was also observed, without rupture, in all three (N-CL, L-CL, M-CL) materials, whereas adhesion to the omentum, but not to the bowel, was observed. The number of blood vessels after 90-day implantation in N-CL and L-CL was 13 ± 1 and 12 ± 1 per field, respectively, while the number significantly decreased to 2 ± 1 in M-CL. The results suggest that the controlled degree of crosslinking in oligourethane-modified biologic implants can be used as a strategy to balance biodegradation and remodeling in surgical repair of soft tissues.

scholarly journals Giant abdominopelvic desmoid tumour herniated trough perineum: a case report

2021 ◽  
Vol 2021 (8) ◽  
Author(s):  
Boyodi Katanga Tchangai ◽  
Mazamaesso Tchaou ◽  
Fousseni Alassani ◽  
Joel Ekoué Amétitovi ◽  
Kwamé Doh ◽  
...  
Keyword(s):  
Case Report ◽  
Adjuvant Treatment ◽  
Functional Outcomes ◽  
Soft Tissues ◽  
Hormonal Treatment ◽  
Desmoid Tumour ◽  
Tumour Resection ◽  
Perineal Approach ◽  
Desmoid Tumours

Abstract Desmoid tumours are deep aggressive fibromatoses that usually arise in the soft tissues of the limbs or the abdominal wall. Intra-abdominal localisation, rarely occurs and their treatment may be challenging. When necessary, surgery must be personalized to what is achievable in terms of margins while preserving functional outcomes. This condition is illustrated herein with the case of a 40-year-old female presenting an unusually large sporadic desmoid tumour with abdominal, pelvic and perineal involvement. Resection was performed without organ involvement through a combined perineal approach. Tumour resection was macroscopically completed except in the perineum, where the tumour was left (R2 resection) to preserve anal sphincter. Adjuvant treatment with tamoxifen was given to achieve local control. The hormonal treatment was well tolerated, and no recurrence was observed after 36 months of follow-up.

Giant desmoid tumour of abdominal wall: resection and reconstruction by posterior component separation

2021 ◽  
Vol 14 (1) ◽  
pp. e239046
Author(s):  
Pankaj Kumar ◽  
Tushar Subhadarshan Mishra ◽  
Mahesh Sethi ◽  
Swastik Mishra
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Rectus Muscle ◽  
Component Separation ◽  
Desmoid Tumour ◽  
Radical Excision ◽  
Team Approach ◽  
Reconstructive Procedures ◽  
Wall Defect ◽  
Posterior Component Separation

Management of large abdominal wall desmoid tumours is complicated due to the unpredictable behaviour of desmoids and the need for laborious reconstruction of the abdominal wall after wide local excision. A multidisciplinary team approach, including surgeons, oncologists and plastic surgeons, is necessary for proper management. This case highlights the diagnostic and surgical challenges related to the reconstruction of abdominal wall defect, after radical excision of a 30×30×25 cm desmoid tumour, originating from left rectus muscle. The defect was closed successfully by a perspicuous technique of posterior component separation. The awareness of this straightforward technique will allow the surgeons to do these radical procedures with confidence and without any consternation of complex reconstructive procedures.

Bio‐Multifunctional Hydrogel Patches for Repairing Full‐Thickness Abdominal Wall Defect

2021 ◽  
pp. 2105614
Author(s):  
Xiangyi Yin ◽  
Yuanping Hao ◽  
Yun Lu ◽  
Dongjie Zhang ◽  
Yaodong Zhao ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Full Thickness ◽  
Wall Defect

Prenatal Diagnosis of a Fetal Abdominal Eventration: A Rare Congenital Abdominal Wall Defect

2007 ◽  
Vol 23 (2) ◽  
pp. 117-120
Author(s):  
Philippe Roth ◽  
Alain Martin ◽  
Fariz Bawab ◽  
Florence Fellmann ◽  
Didier Aubert ◽  
...  
Keyword(s):  
Prenatal Diagnosis ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Wall Defect

A Newborn Who Has an Abdominal Wall Defect

NeoReviews ◽  
2005 ◽  
Vol 6 (3) ◽  
pp. e160-e163
Author(s):  
Valerie Chock
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Wall Defect

Evaluation of TiNi-based wire mesh implant for abdominal wall defect management

2018 ◽  
Vol 4 (2) ◽  
pp. 027010 ◽  
Author(s):  
Dmytro Zaworonkow ◽  
Mykola Chekan ◽  
Katarzyna Kusnierz ◽  
Andrzej Lekstan ◽  
Aniela Grajoszek ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Wire Mesh ◽  
Wall Defect ◽  
Defect Management ◽  
Mesh Implant

The reaction of the soft tissues of the anterior abdominal wall to various suture material

1982 ◽  
Vol 63 (4) ◽  
pp. 72-74
Author(s):  
V. P. Nefedov ◽  
R. M. Ramazanov
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Soft Tissues ◽  
Suture Material ◽  
Anterior Abdominal Wall ◽  
The Body ◽  
Reactive Changes ◽  
Healing Processes

The healing processes of sutured wounds of soft tissues in most cases depend on the type and quality of the suture material. Any kind of suture material in the tissues of the body is a foreign body that causes various reactive changes from the tissues. The nature of these changes, all other things being equal, is mainly determined by the type of suture material, its thickness and the method of sterilization of the tissues on which the sutures are applied, the trauma of surgery, the infection of the wound and the irritating effect of the threads on the tissues.

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