Less-invasive fascia-preserving surgery for abdominal wall desmoid
Abstract The mainstay of treatment for desmoid has been shifted to active surveillance (AS). However, surgery is still being performed on abdominal wall desmoid with a wide surgical margin. The purposes of this study are to clarify the treatment results of less-invasive, fascia preserving surgery fo...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-98775-2 |
| _version_ | 1818718933106032640 |
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| author | Yoshihiro Nishida Shunsuke Hamada Tomohisa Sakai Kan Ito Kunihiro Ikuta Hiroshi Urakawa Hiroshi Koike Shiro Imagama |
| author_facet | Yoshihiro Nishida Shunsuke Hamada Tomohisa Sakai Kan Ito Kunihiro Ikuta Hiroshi Urakawa Hiroshi Koike Shiro Imagama |
| author_sort | Yoshihiro Nishida |
| collection | DOAJ |
| description | Abstract The mainstay of treatment for desmoid has been shifted to active surveillance (AS). However, surgery is still being performed on abdominal wall desmoid with a wide surgical margin. The purposes of this study are to clarify the treatment results of less-invasive, fascia preserving surgery for patients with abdominal wall desmoid, and to propose a new treatment modality. Since 2009, 34 patients with abdominal desmoid have been treated in our institution. Among them, as a final treatment modality, 15 (44%) were successful with AS, 15 were subjected to less-invasive surgery, and 4 methotrexate and vinblastine treatment. The clinical results of less-invasive surgery were clarified. In the surgical group, although the surgical margin was all microscopic positive (R1), only one patient (6.7%), who has the S45F mutation type of CTNNB1, showed recurrence, at a mean follow-up of 45 months. There were no patients with familial adenomatous polyposis (FAP)-related desmoid in this cohort. Only two patients (13%) required fascia lata patch reconstruction after removal of the tumor. In patients with non FAP-related abdominal wall desmoid, less-invasive, fascia preserving surgery is recommended as a favorable option as active treatment. Based on the results of this study, multi-institutional further research is warranted with an increased number of patients. |
| first_indexed | 2024-12-17T19:58:55Z |
| format | Article |
| id | doaj.art-bb8cc918e08145e3b56e847b29781fce |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-17T19:58:55Z |
| publishDate | 2021-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-bb8cc918e08145e3b56e847b29781fce2022-12-21T21:34:32ZengNature PortfolioScientific Reports2045-23222021-09-011111810.1038/s41598-021-98775-2Less-invasive fascia-preserving surgery for abdominal wall desmoidYoshihiro Nishida0Shunsuke Hamada1Tomohisa Sakai2Kan Ito3Kunihiro Ikuta4Hiroshi Urakawa5Hiroshi Koike6Shiro Imagama7Department of Rehabilitation Medicine, Nagoya University HospitalDepartment of Orthopaedic Surgery, Aichi Cancer Center HospitalDepartment of Orthopaedic Surgery, Nagoya University HospitalDepartment of Orthopaedic Surgery, Nagoya University HospitalDepartment of Orthopaedic Surgery, Nagoya University HospitalDepartment of Orthopaedic Surgery, Nagoya University HospitalDepartment of Orthopaedic Surgery, Nagoya University HospitalDepartment of Orthopaedic Surgery, Nagoya University HospitalAbstract The mainstay of treatment for desmoid has been shifted to active surveillance (AS). However, surgery is still being performed on abdominal wall desmoid with a wide surgical margin. The purposes of this study are to clarify the treatment results of less-invasive, fascia preserving surgery for patients with abdominal wall desmoid, and to propose a new treatment modality. Since 2009, 34 patients with abdominal desmoid have been treated in our institution. Among them, as a final treatment modality, 15 (44%) were successful with AS, 15 were subjected to less-invasive surgery, and 4 methotrexate and vinblastine treatment. The clinical results of less-invasive surgery were clarified. In the surgical group, although the surgical margin was all microscopic positive (R1), only one patient (6.7%), who has the S45F mutation type of CTNNB1, showed recurrence, at a mean follow-up of 45 months. There were no patients with familial adenomatous polyposis (FAP)-related desmoid in this cohort. Only two patients (13%) required fascia lata patch reconstruction after removal of the tumor. In patients with non FAP-related abdominal wall desmoid, less-invasive, fascia preserving surgery is recommended as a favorable option as active treatment. Based on the results of this study, multi-institutional further research is warranted with an increased number of patients.https://doi.org/10.1038/s41598-021-98775-2 |
| spellingShingle | Yoshihiro Nishida Shunsuke Hamada Tomohisa Sakai Kan Ito Kunihiro Ikuta Hiroshi Urakawa Hiroshi Koike Shiro Imagama Less-invasive fascia-preserving surgery for abdominal wall desmoid Scientific Reports |
| title | Less-invasive fascia-preserving surgery for abdominal wall desmoid |
| title_full | Less-invasive fascia-preserving surgery for abdominal wall desmoid |
| title_fullStr | Less-invasive fascia-preserving surgery for abdominal wall desmoid |
| title_full_unstemmed | Less-invasive fascia-preserving surgery for abdominal wall desmoid |
| title_short | Less-invasive fascia-preserving surgery for abdominal wall desmoid |
| title_sort | less invasive fascia preserving surgery for abdominal wall desmoid |
| url | https://doi.org/10.1038/s41598-021-98775-2 |
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