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Postoperative perineal hernia.

D E Beck, V W Fazio, D G Jagelman

    Diseases of the Colon and Rectum
    |January 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Surgical repair of symptomatic postoperative perineal hernias is best achieved using Marlex mesh placed through an abdominal approach. This method offers secure fixation and reduces recurrence rates for this rare condition.

    Area of Science:

    • Surgical Oncology
    • Gastroenterology
    • Pelvic Surgery

    Background:

    • Postoperative perineal hernias are uncommon complications following rectal surgery.
    • Seven of eight patients reviewed had prior abdominoperineal resections; one had a pelvic exenteration.

    Purpose of the Study:

    • To evaluate the effectiveness of surgical repair methods for symptomatic postoperative perineal hernias.
    • To identify the optimal surgical approach for managing recurrent perineal hernias.

    Main Methods:

    • Retrospective review of eight patients treated between 1975 and 1986.
    • Comparison of perineal versus abdominal repair approaches using Marlex mesh.
    • Assessment of recurrence rates and operative outcomes.

    Main Results:

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    • Initial perineal repairs resulted in hernia recurrence in both patients.
    • Abdominal approach repair with Marlex mesh showed a lower recurrence rate (one recurrence in six patients).
    • No operative mortality was observed in the study cohort.

    Conclusions:

    • Abdominal approach with Marlex mesh placement is the preferred method for repairing perineal hernias.
    • Secure mesh fixation to pelvic sidewalls and sacral periosteum is crucial.
    • Radiographic confirmation of mesh placement aids in follow-up.