[Repair of abdominal wall defect after resection of abdominal wall endometriosis].
OBJECTIVE
To study the techniques to repair the fascia layer of abdominal wall after the resection of abdominal wall endometriosis (AWE).


METHODS
Fifty-five AWE patients aged 28 approximately 38 underwent resection of the lesion. After the resection a defect fascia in abdominal wall larger than 2 cm(2) was seen in 29 patients (large fascia defect group), and in the other 26 patients the fascia defect was less than 2 cm(2) (small fascia defect group). In the large fascia defect group, 11 cases underwent routine closure of the abdominal wall, 2 underwent abdominal wall reconstruction by applying tension suture, 1 case underwent fascia layer/skin tension-relieving suture, 4 cases abdominal wall reconstruction by PDS-II suture, 4 cases underwent fascia patch grafting, and 7 cases underwent abdominal wall plastic repair plus fascia patch grafting, the different techniques being selected according to the size of the defect. Routine abdominal wall closure was performed on all the 26 patients in the small fascia detect group. The features of the lesion and operation, and the outcomes were compared.


RESULTS
Primary healing was achieved in all the patients. In comparison with the small fascia defect group, the mean size of the masses measured by pre-operational ultrasonography of the large fascia defect group was significantly bigger [(3.8 +/- 1.4) cm vs. (2.5 +/- 1.1 cm)], the mean size of the masses resected in operation was significantly larger [(5, 5 +/- 2.0) cm vs. (3.7 +/- 1.9) cm, P = 0.004], the operation time was significantly longer [(66 +/- 42) min vs. (35 +/- 24) min, P = 0.002], and the intra-operational blood loss was significantly more [(52 +/- 50) ml vs. (23 +/- 19) ml, P = 0.006]. Relapse occurred in 1 case in the large fascia defect group.


CONCLUSIONS
Ultrasonography helps estimate the extension of AWE before operation. Fascia layer/skin tension-relieving suture can be used in the fascia defect of abdominal wall larger than 2 cm(2). Abdominal wall plastic repair plus fascia patch grafting is capable of repairing larger fascia layer and skin defects of abdominal wall.
Cheng
Ning-hai
NH
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhu
Lan
L
Lang
Jing-he
JH
Liu
Zhu-feng
ZF
Sun
Da-wei
DW
Leng
Jin-hua
JH
Shen
Keng
K
Huang
Hui-fang
HF
Pan
Ling-ya
LY
Wu
Ming
M
D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery*; D000328:Adult; D004715:Endometriosis / Q000473:pathology / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*