目的:尽管腹壁纤维瘤病(DF)的治疗在过去的几十年中有所发展,手术治疗仍然是一个重要的方法。以前,腹部DF的手术主要通过剖腹手术进行,涉及到大量的解剖和严重的创伤。这里,我们报道了年轻女性患者腹腔镜治疗腹壁DF的单中心经验.
方法:回顾性分析2020年1月至2022年4月山东大学齐鲁医院收治的9例腹壁DF患者的临床资料。所有患者均接受腹腔镜腹壁DF切除术和立即腹壁重建(AWR),并通过腹膜内嵌网(IPOM)技术进行网片增强。
结果:所有患者均成功进行了腹腔镜DF切除和AWR。平均手术时间为175.56±46.20min。腹壁缺损宽度为8.61±3.30cm。全层和部分厚度肌筋膜闭合和重新逼近在五个,两个,还有两个病人,分别。平均网孔尺寸为253.33±71.01cm2。总住院时间和术后住院时间分别为11.00±3.46天和4.89±2.03天,分别。一名患者在切除20个月后肿瘤复发。尽管如此,死亡,疝气,在平均16.11±8.43个月的随访中,未观察到任何患者出现隆起或隆起.
结论:对于年轻女性患者,腹腔镜腹壁DF切除术和IPOM网状加固的即刻AWR是安全可靠的。此类患者的管理应根据生物学行为决定,尺寸,和肿瘤的位置。
OBJECTIVE: Although the treatment of abdominal wall desmoid-type fibromatosis (DF) has evolved over the past decades, surgical treatment remains an important approach. Previously, surgeries for abdominal DF were mostly performed by laparotomy, which involves massive dissection and significant trauma. Here, we report our single-center experience of the laparoscopic management of abdominal wall DF in young female patients.
METHODS: The clinical data of nine patients diagnosed with abdominal wall DF during January 2020-April 2022 at the Qilu Hospital of Shandong University were retrospectively analyzed. All patients underwent laparoscopic resection of abdominal wall DF and immediate abdominal wall reconstruction (AWR) with mesh augmentation via the intraperitoneal onlay mesh (IPOM) technique.
RESULTS: Laparoscopic DF resection and AWR were successfully performed in all patients. The mean operation time was 175.56 ± 46.20 min. The width of abdominal wall defect was 8.61 ± 3.30 cm. Full- and partial-thickness myofascial closure and reapproximation were performed in five, two, and two patients, respectively. The average mesh size was 253.33 ± 71.01 cm2. The total and postoperative lengths of hospital stay were 11.00 ± 3.46 and 4.89 ± 2.03 days, respectively. Tumor recurred in one patient after 20 months of the resection. Nonetheless, death, herniation, or bulging were not observed in any patient during a mean follow-up of 16.11 ± 8.43 months.
CONCLUSIONS: Laparoscopic resection of abdominal wall DF and immediate AWR with IPOM mesh reinforcement is safe and reliable for young female patients. Management of such patients should be decided according to the biological behavior, size, and location of tumors.