1. [Experience of surgical treatment of abdominal and intraabdominal desmoid fibromas].
- Author
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Khomiakov VM, Cheremisov VV, Chaĭka AV, Vashakmadze LA, Dar'ialova SL, Novikova OV, and Kostrygin AK
- Subjects
- Abdominal Wall pathology, Abdominal Wall surgery, Abdominal Wound Closure Techniques, Adult, Combined Modality Therapy, Female, Humans, Male, Moscow, Postoperative Complications classification, Retrospective Studies, Treatment Outcome, Abdominal Cavity pathology, Abdominal Cavity surgery, Cytoreduction Surgical Procedures adverse effects, Cytoreduction Surgical Procedures methods, Dissection adverse effects, Dissection methods, Fibromatosis, Abdominal pathology, Fibromatosis, Abdominal surgery, Laparotomy adverse effects, Laparotomy methods, Neoplasm Recurrence, Local, Postoperative Complications prevention & control
- Abstract
It is presented the treatment results of abdominal and intraabdominal desmoid fibromas. Group of abdominal localization included 19 patients. 15 of them had primary tumors, 4 - recurrent tumors after surgical treatment. Radical (R0) operations were performed in all cases. Tumor removal was associated with plastic of abdominal wall by synthetic implant in 17 patients. Wide excision of surrounding tissues and musculo-aponeurotic layer of anterior abdominal wall allows to achieve long-term disease-free period. There weren't recurrent symptoms in terms from 4 to 60 months of observation. The second group included 28 patients with intraabdominal desmoid fibromas. Operations were performed in 11 (35.2%) patients including 3 cases of reoperations. There were 14 operations. Radical (R0) volume was applied in 11 (78.6%) operations, cytoreductive (R2) volume - in 1 (7%) operation. Explorative laparotomy was used in 3 (21.4%) cases because of involvement of mesenteric vessels. Combined treatment was performed in 4 (14.3%) patients. 14 (50%) patients received conservative therapy because of unresectable tumor including chemo-, hormone- and radiotherapy. Operated patients were under observation in terms from 11 to 156 months, median was 63.2 months. Recurrence developed in 4 of 10 (40%) patients after R0-surgery. Cytoreductive (R1/R2) volume is admitted for intraabdominal desmoid fibromas. But even in case of unresectable process and explorative intervention stabilization and regression of tumor is possible by means of chemo-, hormone- and radiotherapy in different combination. It allows to preserve a good life quality.
- Published
- 2014