Abdominal Wall Reconstruction Using Omental Flap with Mesh Repair following Resection of Aggressive Abdominal Wall Neoplasms

Abstract

<b><i>Background:</i></b> Resection of large anterior abdominal wall tumors causes large full-thickness abdominal wall defects, and the repair of these defects remains a challenging point. <b><i>Methods:</i></b> Between July 2016 and February 2021, we retrospectively reviewed the internal database registry of the Oncology Center, Mansoura University (OCMU), Egypt, for patients with large abdominal wall defects after abdominal wall tumors resection and repair with omental flaps and synthetic polypropylene (PP) mesh. Thirty-two patients met the inclusion criteria. They were analyzed for demographics and operative data including defect size, mesh size, intra-abdominal tumor extension, and postoperative outcomes and complications. <b><i>Results:</i></b> Thirty-Two patients with abdominal wall neoplasm underwent local resection in our center and the defect was closed with an omental flap and PP mesh. The mean operative time was 143.75 ± 30.77 min. The mean size of the abdominal wall defect was 50.8 cm² (range: 25–90 cm²). The meshes used in reconstruction had a mean size of 89.5 cm² (range: 55–130 cm²). The median follow-up period of the patients was 13.5 months (range: 5–54 months). Postoperative complications included infection (<i>n</i> = 4 cases), seroma (<i>n</i> = 2 cases), hematoma (<i>n</i> = 1 case), and abnormal sensation (<i>n</i> = 5 cases). Tumor recurrence was reported in 2 cases, and no cases developed incisional hernia during the follow-up period. <b><i>Conclusion:</i></b> Immediate use of omental flap with synthetic PP mesh for reconstruction of abdominal wall defects is a feasible technique and has avoided the complications associated with the use of synthetic mesh alone.