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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Autores principales:	Yoshihiro Nishida, Shunsuke Hamada, Tomohisa Sakai, Kan Ito, Kunihiro Ikuta, Hiroshi Urakawa, Hiroshi Koike, Shiro Imagama
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bb8cc918e08145e3b56e847b29781fce
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spelling	oai:doaj.org-article:bb8cc918e08145e3b56e847b29781fce2021-12-02T18:51:07ZLess-invasive fascia-preserving surgery for abdominal wall desmoid10.1038/s41598-021-98775-22045-2322https://doaj.org/article/bb8cc918e08145e3b56e847b29781fce2021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-98775-2https://doaj.org/toc/2045-2322Abstract 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.Yoshihiro NishidaShunsuke HamadaTomohisa SakaiKan ItoKunihiro IkutaHiroshi UrakawaHiroshi KoikeShiro ImagamaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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
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.
format	article
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
title	Less-invasive fascia-preserving surgery for abdominal wall desmoid
title_short	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_sort	less-invasive fascia-preserving surgery for abdominal wall desmoid
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bb8cc918e08145e3b56e847b29781fce
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Less-invasive fascia-preserving surgery for abdominal wall desmoid

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