2020 年 1 巻 1 号 p. 27-32
Background: In the abdominal reconstruction of soft tissue sarcoma (STS), a consistent operative method has not been previously reported. This retrospective case-control study aimed to investigate the characteristics of abdominal STS compared to other areas and to created an algorithm for abdominal reconstruction after STS resection.
Methods: We reviewed the cases of 425 STS patients. Patients were stratified into two groups (abdominal area vs. other areas). We also investigated our reconstruction procedures.
Results: The resection of abdominal STS was performed in 43 cases (10.5%). The reconstruction rate in the abdominal area group was significantly higher than that in the other areas group (33 cases [76.7%] vs. 119 cases [31.2%], p<0.001); similarly, the local or pedicled flap rate was higher in the abdominal area group than in the other areas group (27 cases [81.8%] vs. 48 cases [40.3%], p<0.001). Our algorithm was as follows: Abdominal wall was reconstructed using fascia graft. In the groin region only, pedicled tensor fasciae latae flap (TFL) was performed. In the upper abdominal area, we first tried to perform pedicled rectus abdominis musculocutaneous flap (RAM). In the lower abdominal area, we first tried to perform pedicled muscle sparing transverse RAM and considered performing pedicled anterior lateral thigh + TFL in abdominal wall defect cases.
Conclusions: Since patients commonly need reconstruction of the abdominal wall, the reconstruction rate was high. In all cases, reconstruction could be performed using pedicled flaps and/or fascia graft.