{"title":"Laparoscopic perineal hernia repair after abdominoperineal resection.","authors":"Xin Yuan, Yi Lin Zhu, Xue Fei Zhao, Jie Chen","doi":"10.1007/s10029-025-03288-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Perineal hernia(PH) is a complication after abdominoperineal resection(APR), which is a special kind of incisional hernia, lacking consensus about treatment. This study is aimed at the effect of laparoscopic repair with mesh.</p><p><strong>Methods: </strong>A retrospective study was conducted from Januarary 1st 2015 to December 31st 2023 for the patients undergoing laparoscopic perineal hernia repair after abdominoperineal resection(APR). The data of characteristics, surgery details and follow-up were collected and analysed to evaluate the effect and complications.</p><p><strong>Results: </strong>41 cases were included altogether and all patients received laparoscopy approach, 14 males and 27 females, median age was 70 years(range 45-80years), the mean BMI was 25.04 ± 3.38 kg/m<sup>2</sup>. Operations were completed under laparoscopy in 22 cases, combined with open surgery in 19 cases. 40 cases were treated with synthetic mesh and 1 case with biological mesh. The median operative time was 145 min(range 55-270 min), and the post operative hospital day was 13 days(range 4-47 days). The median follow-up time was 30 months(range 6-103months). There were 2 cases of wound infection and 1 case of intestinal obstruction after operation during in hospital days. 1 cases of recurrence and 2 cases of abnormal sensation in the operation area were observed during the follow-up period. The total incidence of complications was 14.6%.</p><p><strong>Conclusion: </strong>Laparoscopic perineal hernia repair with mesh shows low rates of complications, which is a safe and effective method to perineal hernia after APR. For large defects, hybrid technique helps to close the defect and eliminate dead spaces. The appropriate kind and adequate mesh overlap are critical. Short-term follow up shows positive outcomes in this retrospective study and the controlled trial and long-term follow-up is needed in the future.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"103"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03288-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Perineal hernia(PH) is a complication after abdominoperineal resection(APR), which is a special kind of incisional hernia, lacking consensus about treatment. This study is aimed at the effect of laparoscopic repair with mesh.
Methods: A retrospective study was conducted from Januarary 1st 2015 to December 31st 2023 for the patients undergoing laparoscopic perineal hernia repair after abdominoperineal resection(APR). The data of characteristics, surgery details and follow-up were collected and analysed to evaluate the effect and complications.
Results: 41 cases were included altogether and all patients received laparoscopy approach, 14 males and 27 females, median age was 70 years(range 45-80years), the mean BMI was 25.04 ± 3.38 kg/m2. Operations were completed under laparoscopy in 22 cases, combined with open surgery in 19 cases. 40 cases were treated with synthetic mesh and 1 case with biological mesh. The median operative time was 145 min(range 55-270 min), and the post operative hospital day was 13 days(range 4-47 days). The median follow-up time was 30 months(range 6-103months). There were 2 cases of wound infection and 1 case of intestinal obstruction after operation during in hospital days. 1 cases of recurrence and 2 cases of abnormal sensation in the operation area were observed during the follow-up period. The total incidence of complications was 14.6%.
Conclusion: Laparoscopic perineal hernia repair with mesh shows low rates of complications, which is a safe and effective method to perineal hernia after APR. For large defects, hybrid technique helps to close the defect and eliminate dead spaces. The appropriate kind and adequate mesh overlap are critical. Short-term follow up shows positive outcomes in this retrospective study and the controlled trial and long-term follow-up is needed in the future.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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