To study the feasibility and rationality of surgical treatment of abdominal wall defect caused by colorectal cancer.

From March 2012 to July 2021, 13 cases (10 males and 3 females) of primary or recurrent colorectal cancer with large abdominal wall defects after surgery due to abdominal wall involvement were retrospectively analyzed. The age of the patients ranged from 28~78 (52.6±3.87) years old. There were two cases of recurrent or metastatic tumors and one case of primary colon cancer with abdominal wall involvement. The time between recurrence and the first radical operation ranged from 0.5 to 8 years. The surgical repair method, operation time, intraoperative bleeding, postoperative hospital stay time, complications in the operation area, and follow-up information were recorded.

The maximum diameter of abdominal wall tumor was about 15 cm, and the average are of the abdominal wall defects after resection was about 15 cm×15 cm². The defect of abdominal wall tissue was repaired with the lateral thigh pedicled myocutaneous flap in two cases, the lateral thigh fasciocutaneous flap in six, and the abdominal wall fasciocutaneous flap in five. The biological patch (Cook) was used to repair the defect of the fascia and peritoneum in eight cases. Because of tumor site infection, two cases were treated with a two-step procedure. The lesions were resected and vacuum sealing drainage (VSD) was placed in the first step. And skin flap transplantation was performed after a week of draining. The operation time ranged from 180 to 700 (275±36.62) minutes. The average intraoperative blood loss was (247.6±22.44) ml. The perioperative mortality rate is zero. One patient had subcutaneous fat liquefaction, while another had necrosis and infection of the transferred flap marginal area. All patients were discharged after 10~34 (19.23±5.89) days after operation. Two patients survived for less than 1 year, while another two cases have survived for more than 5 years.

For cases of primary or recurrent colorectal cancer with huge metastasis or involvement of the abdominal wall, after multi-disciplinary discussion, the patients who can benefit from surgery from the aspects of technology and oncology should be carefully weighed from the aspects of oncology, humanistic care, social economics, etc.