BACKGROUND: A perineal hernia can severely disable everyday activities. Its repair is a surgical challenge, and guidance by the literature is limited. The series described so far are small or encompass a long period in which even nonmesh techniques were used. OBJECTIVE: The aim of this study was to review recent results of a perineal mesh-based repair. PATIENTS: Medical charts of patients with a symptomatic perineal hernia after abdominoperineal resection due to rectal cancer were reviewed. MAIN OUTCOME MEASURES: Data included patients' characteristics, operative details, recurrence, and complications. RESULTS: In total, 29 patients underwent repair of a symptomatic perineal hernia after an abdominoperineal resection due to rectal cancer. The majority was male (66%), and the median age was 59 years (range, 41-83). All patients received neoadjuvant treatment.From 2003 until 2006, polytetrafluoroethylene or Vypro mesh and Prolene 2.0 sutures were used for perineal hernia repair. All 8 repairs failed; repeated repair using various methods was successful in 63%. After 2006, the surgical technique was changed into a high-tension repair with the use of a nonabsorbable mesh. This technique was successful for 20 of 21 patients (95%). Complications encountered in the entire group of 29 patients were urinary retention (n = 2), wound infection, seroma, and fistula (n = 1 each). LIMITATIONS: Even though this is the largest group described in the literature, the results are limited because of the small number of patients. CONCLUSION: Repair of perineal hernia remains challenging and only a few reports offer advice on how to manage this unusual problem. However, superior results have been shown with the new mesh-based technique through perineal approach with only 5% recurrence.
BACKGROUND: A perineal hernia can severely disable everyday activities. Its repair is a surgical challenge, and guidance by the literature is limited. The series described so far are small or encompass a long period in which even nonmesh techniques were used. OBJECTIVE: The aim of this study was to review recent results of a perineal mesh-based repair. PATIENTS: Medical charts of patients with a symptomatic perineal hernia after abdominoperineal resection due to rectal cancer were reviewed. MAIN OUTCOME MEASURES: Data included patients' characteristics, operative details, recurrence, and complications. RESULTS: In total, 29 patients underwent repair of a symptomatic perineal hernia after an abdominoperineal resection due to rectal cancer. The majority was male (66%), and the median age was 59 years (range, 41-83). All patients received neoadjuvant treatment.From 2003 until 2006, polytetrafluoroethylene or Vypro mesh and Prolene 2.0 sutures were used for perineal hernia repair. All 8 repairs failed; repeated repair using various methods was successful in 63%. After 2006, the surgical technique was changed into a high-tension repair with the use of a nonabsorbable mesh. This technique was successful for 20 of 21 patients (95%). Complications encountered in the entire group of 29 patients were urinary retention (n = 2), wound infection, seroma, and fistula (n = 1 each). LIMITATIONS: Even though this is the largest group described in the literature, the results are limited because of the small number of patients. CONCLUSION: Repair of perineal hernia remains challenging and only a few reports offer advice on how to manage this unusual problem. However, superior results have been shown with the new mesh-based technique through perineal approach with only 5% recurrence.
Authors: K Bertrand; J H Lefevre; B Creavin; M Luong; C Debove; T Voron; N Chafai; E Tiret; Y Parc Journal: Hernia Date: 2019-03-18 Impact factor: 4.739
Authors: A Balla; G Batista Rodríguez; N Buonomo; C Martinez; P Hernández; J Bollo; E M Targarona Journal: Tech Coloproctol Date: 2017-05-15 Impact factor: 3.781
Authors: George Melich; Dae Ro Lim; Hyuk Hur; Byung Soh Min; Seung Hyuk Baik; Goffredo O Arena; Philip H Gordon; Nam Kyu Kim Journal: Can J Surg Date: 2016-02 Impact factor: 2.089