Background: Intra-abdominal desmoids are uncommon neoplasms. The aggressive
nature of these tumours and the potential for major morbidity secondary to
resection can present a difficult surgical dilemma.
Methods:Patients with histologically confirmed intra-abdominal desmoid tumo
urs undergoing laparotomy were identified from a prospective database, Clin
ical features and outcomes in this group were evaluated.
Results: The study group comprised 24 patients. Sixteen patients underwent
complete resection of the tumour while eight had biopsy only, with or witho
ut intestinal bypass. Small intestinal resection was performed in 12 patien
ts, including three who had a near-total enterectomy, Median follow-up was
62 months, with an actuarial overall survival rate of 73 per cent at 10 yea
rs, There was no difference in survival rare between completely resected an
d unresected patients (P=0.73). There were seven deaths in the entire group
, of which four were in those undergoing complete resection.
Conclusion: Operation can cure patients with intra-abdominal desmoid rumour
s, but may result in significant morbidity, especially from loss of small i
ntestine. No other therapy is a predictably good alternative to operation b
ut the natural history of desmoids is often characterized by prolonged peri
ods of stability or even regression. A period of watchful waiting, until si
gnificant symptoms develop, may be the most appropriate course in patients
who risk mesenteric vascular injury or substantial enterectomy with attempt
s at resection.