6 Cases of Expanded PTFE Graft after Abdominal Wall Wide Excision

Seo, Jung Pil; Choi, Kyun Hyun

Abstract

PURPOSE: Extensive involvement of the abdominal wall or the diaphragm by benign or malignant tumor usually has precluded wide excision. The major reason has been the lack of a satisfactory replacement for the abdominal wall or the diaphragm. When skin and subcutaneous tissues can be preserved, it is possible to restore the abdominal wall or diaphragm by using expanded polytetrafluoroethylene (GORE-TEX soft tissue patch).
METHODS
From August 1993 to November 1999, we performed 6 reconstructions of the large abdominal wall or diaphragmatic defects using ePTFE following wide en bloc resection of the abdominal wall or diaphragm.
RESULTS
The patients included 4 cases requiring a reconstruction of the abdominal wall. These consisted of one transverse colon cancer invading into the upper abdominal wall, a multiple teratoma recurring in the lower part of the abdominal wall, a recurrent cervix cancer inn the median line of the lower part of the abdominal wall, and an enormous desmoid tumor appearing in the right lower part of the abdominal wall. They were 22, 22, 8 and 4 months respectively after the surgical treatment. Diseases requiring extensive resection of the diaphragm included a case of hepatoma encroaching into the diaphragm and another case of a huge adrenal pheochromocytoma appearing in the right part of the diaphragm. They passed 8 and 4 months respectively following surgical treatment. There were no cases of wound infection or abdominal wall hernia, although seroma occurred in 2 cases (50%).
CONCLUSION
In all 6 cases, a good result was achieved by restoring excised tissue using ePTFE graft after wide excision of tumors involving the abdominal wall or the diaphragm. Therefore, it may be possible to use this technique in cases of active excision of tumors that involve an extensive part of the abdominal wall or the diaphragm.