Management of huge defects following extensive abdominal wall neoplasm resection: classification and immediate reconstruction

Objective To evaluate the effect of extensive resection and immediate reconstruction based on classification of abdominal wall defects for patients with abdominal wall neoplasms. Methods From Jan 1999 to May 2016, 112 patients with abdominal wall neoplasms were treated with extensive resection, including Type Ⅰ (n=20), Type Ⅱ (n=45) and Type Ⅲ (n=47). Immediate abdominal wall reconstruction comprised primary sutures or free skin graft for Type I defects, component separation (CST) with or without a prosthetic or biological mesh reinforcement for Type Ⅱ defects and pedicled or vascularized myocutaneous flap with or without a prosthetic or biological mesh or prosthetic + biological mesh with or without CST for Type Ⅲ defects. Results The average follow up was 76.86±21.22 months, 3 patients developed flap necrosis, 9 patients suffered from wound infection. Local recurrence was observed in 20 patients, 35 patients developed distant metastasis. Conclusions The optimal strategy based on the abdominal wall defect classification for immediate reconstruction of huge abdominal wall defects is safe and effective after resection of abdominal wall neoplasms. Key words: Abdominal wall; Neoplasms; Extensive resection; Immediate reconstruction