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Abdominal wall mass resections: single-center closure practices and outcomes following oncologic resections of abdominal wall fascia.
Maskal, S; Chang, J; Ellis, R; Messer, N; Melland-Smith, M; Tu, C; Miller, B; Petro, C; Simon, R; Prabhu, A; Rosen, M; Beffa, L.
Afiliación
  • Maskal S; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA. Maskals2@ccf.org.
  • Chang J; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Ellis R; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Messer N; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Melland-Smith M; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Tu C; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Miller B; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Petro C; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Simon R; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Prabhu A; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Rosen M; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
  • Beffa L; Department of Surgery, Cleveland Clinic, 2049 E 100th St, A-100, Cleveland, OH, 44106, USA.
Hernia ; 28(2): 457-464, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38062203
PURPOSE: Radical resections for abdominal wall tumors are rare, thus yielding limited data on reconstruction of defects. We describe surgical management and long-term outcomes following radical tumor resection. METHODS: This was a single-center retrospective review of patients between January 2010 and December 2022. Variables included operative characteristics, wound complications, hernia development, tumor recurrence, and reoperation. A multivariable analysis compared wound morbidity for suture and mesh repairs while adjusting for defect width, fascial closure, and CDC wound class. RESULTS: 120 patients were identified. Mean follow-up was 3.9 ± 3.4 years. Seventy-five (62.5%) of the masses were primary; most commonly desmoid (n = 25) and endometrioma (n = 27). Forty-five masses were metastases. Mean tumor width was 6.2 ± 3.4 cm; mean defect width was 8.1 ± 4.1 cm. Sixty-one patients (50.8%) had mesh placed, with variation in technique. Postoperative CT scans were available for 88 (73.3%) patients. Forty SSOs (33.3%), 11 SSIs (9.2%), and 18 (15%) SSOPIs occurred within 30 days. On multivariable analysis, increased defect width was associated with SSOPI (OR 1.17, p = 0.041) and CDC wound class II-III was associated with SSI (OR 8.38 and 49.1, p < 0.05) and SSOPI (OR 5.77 and 17.4, p < 0.05); mesh was not associated with these outcomes. Seven patients (5.8%) underwent 30-day reoperations and 35 (20.8%) required additional operations after 30 days. Thirteen percent developed abdominal wall (n = 8) or intra-abdominal tumor recurrence (n = 8) requiring reoperation. Twenty-seven (22.5%) patients developed hernias with a mean fascial defect width of 9.8 ± 7.2 cm. CONCLUSION: Abdominal wall mass resections are morbid, often contaminated cases with high postoperative complication rates. Risks and benefits of mesh implantation should be tailored on an individual basis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pared Abdominal / Hernia Ventral Límite: Humans Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pared Abdominal / Hernia Ventral Límite: Humans Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia