Rectus abdominis muscle resection for abdominal wall recurrence of mucinous adenocarcinoma or peritoneal mesothelioma
Tuesday, August 19th, 2008.
Tumori. 2008 May-Jun;94(3):309-13.[Link]
Yan T, Sugarbaker P.
Peritoneal Surface Malignancy Program, Washington Cancer Institute, Washington Hospital Center, Washington, DC 20010, USA.
Abstract
Aims and Background: Diagnostic technologies which penetrate the abdominal wall in an attempt to definitively diagnose an intraabdominal malignancy by biopsy can contaminate the abdominal wall by cancerous cells. With follow-up these entrapped cancer cells may progress as an abdominal wall recurrence of the disease process. Frequently, laparoscopy is the definitive diagnostic study which results in the abdominal wall cancer progression.
Methods: We examined recurrences within the abdominal wall and attempted to establish a surgical approach to this problem which would maximize a functional result and minimize the incidence of disease persistence within the abdominal wall.
Results: Eighteen patients with abdominal wall recurrence were studied. Laparoscopy port sites resulted in the abdominal wall disease in eight patients, in four the recurrence was at a previous ostomy site, in three it was in a Pfannenstiel incision and in three it was in a McBurney incision site. All of these patients were treated by total resection of the rectus abdominis muscle. This resulted in a complete removal of visible disease that was dissecting along the fibers of the rectus abdominis muscle.
Conclusions: No patients required reoperation for abdominal wall hernia and mesh repair was not used in any of these patients. Disease control within the abdominal wall has been excellent.
i read this study two years ago and it saved my life. my local drs. were dumfounded by the colon cancer recurrence in my abdmonial wall which presented itself shortly after a laparoscopic removal was attempted of a large sigmoid tumor. Because the tumor was too large, a traditional removal was made; however, the tracking caused by the laparoscope has caused me untold grief, pain, additional years of chemotherapy, radiation and two additional surgeries.Initially, my oncologist said that surgery of the abdominal tumor was not an option. Thank God i found your study. Upon showing it to my dr., i was sent to the Moffitt Hospital in Tampa Florida where my abdominus rectus was successfully resected. my surgeon there is Dr. David Shibata. Two months later i had another recurrence in my small bowel, caused by dropped cells. This was also removed at Moffitt. i am very grateful to say that a year since has passed with no recurrences and clean pet scans. i sincerely hope no other cancer patient endures my own history. i know that if my first tumor had not been touched by a laparocope, i could have been spared unspeakable pain and grief. i am a 45 year old mother of three teenagers, very grateful to still be here. Thank you!
i would be happy to share the details of my case if it could be of any benefit to a larger study.
Most sincerely,
Sandy Sepehri