Outcomes of flap reconstruction techniques in abdominal wall defects following oncologic resections
DOI:
https://doi.org/10.56183/iberojhr.v4i2.647Palavras-chave:
Flap Reconstruction, Abdominal Wall Defects, Oncologic Resections, Cancer surgery, Post-Oncologic Defects, Complications.Resumo
Abdominal wall defects following oncologic resections present significant challenges and require careful planning and execution to restore both structural integrity and function. Defects that arise from aggressive tumor excisions that necessitate the removal of large portions of skin, muscle, and fascia. Various flap reconstruction techniques: Ramirez component separation and Rives-Stoppa repair employ mesh prosthetics for tension-free and secure closures. We synthesized findings from multiple studies to evaluate the efficacy, safety, and outcomes of these techniques. After all research, we can indicate that while local, regional, and free flaps each offer unique benefits successful reconstruction depends on a personalized approach that considers defect size, location, and patient-specific factors. Short-term outcomes show complication rates ranging from 17.4% to 39% with common issues including infections, hernia recurrence, and wound healing problems. Long-term outcomes highlight the importance of functional and aesthetic restoration, with recurrence rates for hernias and other complications varying widely depending on the technique used. Long-term outcomes of flap reconstruction techniques in abdominal wall defects following oncologic resections show a complication rate of 25% for various flap techniques.
Referências
Larson, J. D., Altman, A. M., Bentz, M. L., & Larson, D. L. (2014). Pressure ulcers and perineal reconstruction. Plastic and Reconstructive Surgery, 133(1), 39e-48e.
Garcia-Henriquez, N., Galante, D. J., & Monson, J. R. (2020). Selection and outcomes in abdominoperineal resection. Frontiers in Oncology, 10, 1339.
Pogson-Morowitz, K., Fimbres, D. P., Barrow, B. E., Oleck, N. C., & Patel, A. (2024). Contemporary abdominal wall reconstruction: Emerging techniques and trends. Journal of Clinical Medicine, 13(10), 2876. https://doi.org/10.3390/jcm13102876
Han, H., Li, R., Yang, S., Liu, X., Sun, M., & Lu, J. (2024). Surgical techniques and effectiveness of laparoscopic resection of abdominal wall desmoid-type fibromatosis and defect reconstruction: a single-center retrospective analysis. Hernia, 28(1), 211-222.
Sun, C., Guo, C., Bai, X., Sun, Y., Zhao, D., Chen, Y., & Zhou, H. (2024). The Management for the Complications Associated with Gastrectomy. In Interpretation of Gastric Cancer Cases (pp. 115-139). Singapore: Springer Nature Singapore.
Smit, J. M., Plat, V. D., Panday, A. N., Daams, F., & Negenborn, V. L. (2024). What are the short‐and long‐term abdominal consequences of an omentectomy? A systematic review. Journal of Surgical Oncology.
Pilco, R. M. P., Salazar, E. R. A., Lasso, J. S. O., Quiroz, F. D. C., Barberan, O. S. V., Pesantes, L. H. I., & Parrado, J. D. G. (2024). Functional and aesthetic outcomes of combined reconstructive tchniques in complex abdominal surgery. Ibero-American Journal of Health Science Research, 4(2), 64-71.
Hope, W. W., Abdul, W., & Winters, R. (2023, July 24). Abdominal wall reconstruction. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK431108/
Kostov, S., Selçuk, I., Watrowski, R., Dineva, S., Kornovski, Y., Slavchev, S., ... & Yordanov, A. (2024). Neglected Anatomical Areas in Ovarian Cancer: Significance for Optimal Debulking Surgery. Cancers, 16(2), 285.
Buell, J. F., Flaris, A. N., Raju, S., Hauch, A., Darden, M., & Parker, G. G. (2021). Long-Term outcomes in complex abdominal wall reconstruction repaired with absorbable biologic polymer scaffold (Poly-4-Hydroxybutyrate). Annals of Surgery Open, 2(1), e032. https://doi.org/10.1097/as9.0000000000000032
Puscz, F., Lehnhardt, M., & Wallner, C. (2024). Surgical Treatment and Innovations in Soft Tissue Sarcoma Care.
Facs, M. a. G. M. (2023) Abdominal wall reconstruction treatment & management: preoperative details, intraoperative details, complications. https://emedicine.medscape.com/article/1297226-treatment
Popa, F., & Georgescu, A. V. (2017). Abdominal Wall Reconstruction after Flap Surgery and the Effect on the Immune System. BioMed Research International, 2017, 1–10. https://doi.org/10.1155/2017/2421585
Smit JM, Plat VD, Panday AN, Daams F, Negenborn VL. What are the short‐ and long‐term abdominal consequences of an omentectomy? A systematic review. Journal of Surgical Oncology [Internet]. 2024 Apr 12;129(8):1420–9. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/jso.27640
Song, Z., Yang, D., Yang, J., Nie, X., Wu, J., Song, H., & Gu, Y. (2018). Abdominal wall reconstruction following resection of large abdominal aggressive neoplasms using tensor fascia lata flap with or without mesh reinforcement. Hernia, 22(2), 333–341. https://doi.org/10.1007/s10029-018-1738-8
Zhong, T., Janis, J. E., Ahmad, J., & Hofer, S. O. P. (2011). Outcomes after abdominal wall reconstruction using acellular dermal matrix: A systematic review. Journal of Plastic Reconstructive & Aesthetic Surgery, 64(12), 1562–1571. https://doi.org/10.1016/j.bjps.2011.04.035
Bailey, C. M., Schaverien, M. V., Garvey, P. B., Liu, J., Butler, C. E., & Mericli, A. F. (2020). The impact of sarcopenia on oncologic abdominal wall reconstruction. Journal of Surgical Oncology, 122(7), 1490–1497. https://doi.org/10.1002/jso.26171
Hassan, A. M., Franco, C. M., Shah, N. R., Netherton, T. J., Mericli, A. F., Garvey, P. P., Schaverien, M. V., Chang, E. I., Hanasono, M. M., Selber, J. C., & Butler, C. E. (2023). Outcomes of complex abdominal wall reconstruction after oncologic resection: 14-Year experience at an NCI-Designated cancer Center. Annals of Surgical Oncology, 30(6), 3712–3720. https://doi.org/10.1245/s10434-023-13098-y
Zhao, X., Cao, Z., Nie, Y., Liu, J., Yuan, X., Chen, J., & Shen, Y. (2020). Retrospective analysis of defect reconstruction after abdominal wall tumor resection in 30 patients. Hernia, 25(2), 375–381. https://doi.org/10.1007/s10029-020-02219-1
Lee, K., Kim, J., Jeon, B. J., Pyon, J. K., Bang, S. I., & Mun, G. (2023). Longitudinal analysis of long-term outcomes of abdominal flap-based microsurgical reconstruction and two-stage prosthetic reconstruction. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-31218-2
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Copyright (c) 2024 Daniela Monserrath Zúñiga Salgado; Mauro Francisco Marchán Morales; Martín Ignacio Pinos Tafur, Ana Gabriella Quiroz González, Christian Camilo Romero Amaya
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
