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Long-term follow-up of total abdominal wall reconstruction for prune belly syndrome
Malcolm A Lesavoy1, Eric I Chang, Ahmed Suliman
1Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, Los Angeles Medical Center.
Insights
This study shows that the double-breasted technique for total abdominal wall reconstruction is a safe and effective method for treating prune belly syndrome (PBS). The procedure offers excellent cosmetic results and patient satisfaction with long-term durability.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Congenital Malformations
Background:
- Prune belly syndrome (PBS) is a rare congenital disorder characterized by abdominal wall muscle deficiency, cryptorchidism, and genitourinary anomalies.
- Reconstructing the abdominal wall in PBS patients presents significant surgical challenges.
Purpose of the Study:
- To evaluate the long-term safety, durability, and cosmetic outcomes of a specific total abdominal wall reconstruction technique in patients with prune belly syndrome.
- To present one of the largest patient series with the longest follow-up for this reconstructive approach.
Main Methods:
- The study reviewed the experience of 20 patients undergoing total abdominal wall reconstruction using a previously described "double-breasted" medial fascial advancement technique.
- This method allowed for simultaneous urinary tract reconstruction and bilateral orchiopexy, with preservation of the umbilicus.
Main Results:
- A mean follow-up of 20.4 years revealed no major complications in the 20 patients.
- All patients reported high satisfaction with their postoperative cosmetic and functional results.
Conclusions:
- Total abdominal wall reconstruction utilizing the double-breasted technique is a safe and durable surgical option for prune belly syndrome.
- This approach yields excellent cosmetic outcomes and high patient satisfaction in the long term.
Background:
Prune belly syndrome is a rare, congenital condition that consists of a major deficiency or hypoplasia of the abdominal wall musculature, bilateral cryptorchidism, and genitourinary tract malformations. Reconstruction of the abdominal wall in these patients has presented a challenge to plastic surgeons throughout the years.
Methods:
The authors previously described a technique for total abdominal wall reconstruction that permitted simultaneous urinary tract reconstruction and bilateral orchiopexy. This innovative procedure used medial advancement of the fascia in a "double-breasted" fashion with preservation of the umbilicus. The authors reviewed their experience with this particular technique in one of the largest series of patients in the literature and the series with the longest follow-up.
Results:
Twenty patients underwent total abdominal wall reconstruction with simultaneous urinary tract reconstruction and orchiopexy with a mean follow-up of 20.4 years. There were no major complications noted during this period, and all patients were extremely satisfied with their postoperative result.
Conclusion:
Total abdominal wall reconstruction using the double-breasted technique in patients with prune belly syndrome is a safe and durable procedure that achieves excellent cosmetic results.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
