探讨腹腔镜肿瘤切除联合腹壁重建治疗年轻女性腹壁侵袭性纤维瘤病的临床效果与安全性。

纳入2020年1月至2023年3月，山东大学齐鲁医院疝与腹壁外科行腹腔镜肿瘤切除联合腹壁重建的腹壁侵袭性纤维瘤病患者，共12例，对患者的临床病理数据及随访资料进行回顾性分析。分析患者的临床特征、手术相关指标及随访并发症发生情况。

12例患者，均为青年女性，平均年龄（32.33±6.02）岁。所有患者均成功施行腹腔镜肿瘤切除联合腹壁重建，平均手术时间为（173.75±39.55）min，6例行全层肌肉筋膜关闭，2例行非全层肌肉筋膜关闭，4例由于腹壁缺损巨大或缺损位于髂骨上方，采用部分缝合的方式缩小腹壁缺损。肿瘤切除后腹壁缺损大小为（9.79±2.94）cm×（8.21±2.93）cm；缺损修补所用补片平均面积为（259.58±62.35）cm²。患者中位住院时间为11.50 d，术后第3天活动时数字评定量表疼痛评分均值为（2.42±1.00）分。术后中位随访时间为16.50个月。随访期间，1例术后CT检查时发现血清肿；3例偶有腹壁局部感觉异常，但对日常生活无显著影响；1例在术后20个月肿瘤复发，所有患者均未出现死亡、血肿、手术部位感染或补片感染以及腹壁疝或腹壁膨出。

在充分术前评估的前提下，腹腔镜肿瘤切除联合腹壁重建治疗青年女性腹壁侵袭性纤维瘤病是可行且安全的。

To investigate the effect and safety of laparoscopic tumor resection and immediate abdominal wall reconstruction for the abdominal wall aggressive fibromatosis in young women.

In the present study, we retrospectively analyzed the clinical, pathological and follow-up data of 12 patients with abdominal wall aggressive fibromatosis. All the patients underwent laparoscopic tumor resection and immediate abdominal wall reconstruction in the Department of Hernia and Abdominal Wall Surgery in Qilu Hospital of Shandong University from January 2020 to March 2023. The clinical characteristics, surgical related indicators and follow-up complications of the patients were analyzed.

All 12 patients were young women with a mean age of (32.33±6.02) years. Laparoscopic tumor resection and immediate abdominal wall reconstruction were successfully conducted in all patients, with a mean operative duration of (173.75±39.55) min. Six patients underwent full-thickness myofascial closure, two patients underwent partial-thickness myofascial closure, while four patients underwent partial suture to reduce the abdominal wall defect because the defect was large or located above the iliac bone. The mean size of abdominal wall defects after tumor resection was (9.79±2.94) cm × (8.21±2.93) cm, respectively. The mean area of mesh for defect repair was (259.58±62.35) cm². The median hospital stay was 11.50 days. The mean Numerical Rating Scale (NRS) score for pain on the third day after surgery was (2.42±1.00). The median follow-up duration was 16.50 months. During the follow-up period, seroma was found in 1 patient during postoperative CT examination; 3 patients had occasional local discomfort of abdominal wall, which had no significant impact on daily life; 1 patient had tumor recurrence 20 months after surgery. None of the patients died or had hematoma, surgical site/mesh infection, or abdominal wall hernia/bulge.

After fully preoperative evaluation, laparoscopic tumor resection combined with immediate abdominal wall reconstruction is feasible and safe for the treatment of abdominal wall aggressive fibromatosis in young women.