To summarize the treatment experience in reconstruction of abdominal wall defect following surgical resection of abdominal wall tumors in Zhongshan Hospital, Fudan University over the past three years, and to provide reference for subsequent clinical diagnosis and treatment of abdominal wall tumors.

Clinical data including patients' baseline characteristics, abdominal wall tumor characteristics, surgical details and postoperative recovery data from 39 patients who underwent surgical treatment for malignant and borderline abdominal wall tumors in Zhongshan Hospital, Fudan University between January 2022 and March 2025 were retrospectively collected, sorted, and analyzed. Further univariate analysis was conducted on the influence of abdominal wall tumors and surgical factors on postoperative complications.

Among the 39 patients, the average maximum width of malignant tumors in the abdominal wall was (4.9±3.0) cm, and the average maximum width of abdominal wall defects was (7.0±3.3) cm. There were 11, 16, and 12 cases of Type Ⅰ, Ⅱ, and Ⅲ abdominal wall defects respectively. Type Ⅱ defects were more common. There were 8 patients with defects located in the U-zone, 10 in the M-zone, 20 in the L-zone, and 1 in the M+L-zone, with the L area being the most common, accounting for 51.3%. Grade 1 defects were more common (66.7%, 26/39), grade 2 and 3 defects were 7.7% (3/39) and 25.6% (10/39), respectively. There were 13 types of tumors on postoperative pathology. Most of the tumors originated from primary tumors (46.2%, 18/39). Intraoperatively, 20 patients underwent simple suture closure, 16 received mesh repair, and 3 underwent free flap reconstruction of the abdominal wall after tumor resection. Postoperatively, the incidence of Clavien-Dindo Grade Ⅱ and Ⅲ complications were both 2.6% (1/39) and no mesh-related complications occurred. The median of hospital stay was 4 (2, 5) days, and no patients required unplanned readmission within 30 days after discharge. Within three months after discharge, 30.8% (12/39) of patients developed tumor metastasis, 21.3% (9/39) experienced abdominal wall tumor recurrence, and no patients died during follow-up. Univariate analysis found that grade 3 abdominal wall defect was associated with the occurrence of postoperative complications (P=0.043).

The clinical management of abdominal wall tumors is complicated and variable, because of diverse patient-specific factors, tumor size, and disease progression, which require individualized selection of repair methods and materials. This study shows that mesh repair for abdominal wall defects after tumor resection is safe and reliable, but further clinical studies are needed to provide additional data for reference.