This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
A 10‐year review of surgery for desmoid disease associated with familial adenomatous polyposis. BJS 2006; 93: 1258-1264.
Published: 4th September 2006
Authors: A. R. Latchford, N. J. H. Sturt, K. Neale, P. A. Rogers, R. K. S. Phillips
Background
Desmoid tumours affect 10–25 per cent of patients with familial adenomatous polyposis and represent a major cause of morbidity and mortality. Surgery for intra‐abdominal desmoids has traditionally been used as a last resort or to manage obstructive complications. The aim was to review 10 years of desmoid surgery in patients with familial adenomatous polyposis from a single centre.
Method
Patients who had surgery for desmoid disease between 1994 and 2004 were identified from the Polyposis Registry database and their hospital notes reviewed.
Results
Twenty patients had surgery to remove 32 desmoid tumours (16 intra‐abdominal, 12 abdominal wall, four extra‐abdominal). Complete clearance was achieved in 19 tumours and, of these, clinically significant recurrence occurred in eight. There was no difference in recurrence rates for site or sex. There was no operative mortality. Intra‐abdominal desmoid resection was associated with a mean resection of 45·55 (range 10–200) cm of small bowel. One patient required long‐term parenteral feeding. Median follow‐up was 5 (range 0·6–10) years. During this period, one patient died (metastatic duodenal cancer); there was no mortality from desmoid disease.
Conclusion
Surgery for intra‐abdominal desmoids in selected patients is less hazardous than previously reported. Surgery for abdominal wall and extra‐abdominal tumours is safe. However, disease recurrence remains a major problem. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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