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221 Complex abdominal wall reconstruction for an isolated parietal recurrence of ovarian cancer
  1. Manel Montesinos-Albert1 and
  2. Carlos Martinez-Gómez2
  1. 1Hospital Universitari i Politècnic La Fe, Valencia, Spain
  2. 2Department of Surgical Oncology, Lille, France


Introduction/Background Abdominal wall involvement in gynecological malignancies can present a surgical challenge. To reduce the risk of postoperative hernia, there are several options available to restore abdominal wall integrity. These options can be utilized depending on the specific circumstances and requirements of the patient.

In an active oncologic context, biological meshes and autologous flaps are often preferred over synthetic meshes for abdominal wall reconstruction. This is because biological meshes and autologous flaps carry a lower risk of mesh infection, exposure, and colonization by tumor cells.1 Additionally, they can provide satisfactory long-term functional outcomes.2 This preoperative planning helps ensure the most appropriate choice for abdominal wall reconstruction in the given oncologic context.

Methodology We present a case of a patient who was treated for endometrioid ovarian cancer FIGO IIIC2 in 2017 and experienced an isolated abdominal wall relapse in December 2022. The patient underwent a surgical resection with en-bloc full-thickness parietal resection,3 and the abdominal wall reconstruction was planned using a biological mesh fixed to the rectus abdominis, covered by a pedicled anterolateral thigh fasciocutaneous flap.4 The patient was discharged on the 10th postoperative day. The anatomopathological analysis revealed a low-grade endometrioid adenocarcinoma with tumor-free surgical margins. On the 30th postoperative day, the patient experienced an infected lymphocele of the thigh, which was successfully managed with percutaneous drainage and antibiotics. No mesh removal was required, and adjuvant chemotherapy was started within the 6th postoperative week.

Results This case highlights the potential benefits of using a combined approach involving biological meshes and autologous flaps to achieve satisfactory functional, oncologic, and cosmetic outcomes while minimizing the postoperative risks and delays in adjuvant treatments.

Conclusion Pedicled fasciocutaneous thigh flaps and biological meshes may represent a good alternative for abdominal wall reconstruction in an oncologic context.


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  3. Harter P, Sehouli J, Vergote I, Ferron G, Reuss A, Meier W, et al. Randomized trial of cytoreductive surgery for relapsed ovarian cancer. N Engl J Med [Prieiga per internetą]. 2021 m. gruodžio 2 d.;385(23):2123–31. Available at:

  4. Kimata Y, Uchiyama K, Sekido M, Sakuraba M, Iida H, Nakatsuka T, et al. Anterolateral thigh flap for abdominal wall reconstruction. Plast Reconstr Surg [Prieiga per internetą]. 1999 m. balandžio;103(4):1191–7. Available at:

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