Year: 2025 | Month: November | Volume: 15 | Issue: 11 | Pages: 90-96
DOI: https://doi.org/10.52403/ijhsr.20251112
Double Mesh Sandwich Repair for Abdominal Wall Defects Following Wide Excision of Desmoid Tumours: A Retrospective Analysis of Monocentric Surgical Experience and Systematic Review of Literature
Dr. Joseph Francis1, Dr. Linta Maria David2
1MBBS, MS, Associate Professor, Department of General Surgery, Travancore Medical College, Kollam, Kerala.
2MBBS, Junior Resident, Department of General Surgery, Travancore Medical College, Kollam, Kerala.
Corresponding Author: Dr. Joseph Francis
ABSTRACT
Background: Desmoid tumours of the abdominal wall are rare, locally aggressive fibroblastic neoplasms that often arise in females, particularly following pregnancy or abdominal surgery. Surgical excision with adequate margins remains the mainstay treatment; however, large resultant defects pose a significant reconstructive challenge. This study presents a retrospective case series of five female patients treated with the double mesh “sandwich” repair technique, along with a systematic review of published literature on abdominal wall desmoid tumour reconstruction.
Methods: Five consecutive patients treated between January 2016 and June 2025 were retrospectively analysed. All were females, of which three patients had prior history of lower segment caesarean section, diagnosed with abdominal wall desmoid tumours confirmed histopathologically. The “double mesh sandwich repair” technique was used for reconstruction following wide local excision. Demographic data, intraoperative details and postoperative outcomes were recorded. A systematic review of existing literature was conducted following PRISMA guidelines with an emphasis on the surgical technique and outcome.
Results: Complete tumour excision with negative margins was achieved in all patients. The mean defect size was 57.2 ± 30.4cm². The double mesh repair technique provided excellent abdominal wall strength and contour with no mesh-related infections during the follow-up duration ranging from 6 to 116 months. One out of the five patients, however developed recurrence [7 mm lesion in the subcutaneous plane] after 1 year, which was detected in follow up CT scan, despite resection of the tumour with clear margins. Cosmetic outcomes and patient satisfaction were favourable. The systematic review also supports the growing use of double mesh repair technique in complex abdominal wall reconstructions.
Key words: Desmoid tumour, Abdominal wall reconstruction, Double mesh sandwich repair, Fibromatosis