LAUSR

Presentation through a clinical case of complex reconstruction of the abdominal wall after resection of a parietal metastatic lesion in a difficult location. A 56-year-old male with T3N0M0 adenocarcinoma of the rectum underwent Hartmann's surgery in 2018 with subsequent cytoreductive surgery (CRS) + HIPEC in 2019 due to relapse of his disease. He presented a second relapse of CRC in the form of a parietal lesion of 8×5×6cm with bilateral involvement of the anterior rectus abdominis muscle and contact with the symphysis of the pubis. The operative findings showed a large tumor with involvement of both rectus abdominis muscles and the pubic symphysis. Complete resection of the lesion is performed and treatment is completed with HIPEC cycle with MMC in a total of 5 hours. Reconstruction was performed using intraperitoneal biological mesh prosthesis in the area of the parietal defect, together with placement of supra-aponeurotic polypropylene mesh. The patient did not present specific complications of abdominal reconstruction (SSO) and was discharged in 11 days. The association of complex abdominal reconstruction techniques after cytoreduction surgery + HIPEC seems to increase the morbidity rates of these patients according to several studies. However, in our experience the use of abdominal wall reconstruction techniques after CRS and HIPEC is safe and does not increase complications, presenting good functional and oncologic results.