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Postoperative perineal hernia

J B So1, M T Palmer, P C Shellito

  • 1Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, USA.

Diseases of the Colon and Rectum
|August 1, 1997
PubMed
Summary
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Perineal hernias are a rare complication after abdominoperineal resection. Primary wound closure and avoiding infection are key to prevention, with perineal repair offering successful outcomes.

Area of Science:

  • Surgical oncology
  • Gastrointestinal surgery
  • Pelvic reconstructive surgery

Background:

  • Perineal hernia is an uncommon complication following abdominoperineal resection (APR).
  • Understanding predisposing factors and optimal repair strategies is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate predisposing factors for perineal hernia after pelvic surgery.
  • To determine the most effective methods for repairing perineal hernias.

Main Methods:

  • Retrospective review of patients diagnosed with postoperative perineal hernia.
  • Analysis of original surgical procedures, hernia repair techniques, and patient outcomes.
  • Data collected from Massachusetts General Hospital between 1963 and 1995.

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Main Results:

  • Twenty-one cases of perineal hernia were identified.
  • The incidence following APR was 0.62%.
  • Common factors included open perineal wounds (69%) and unrepaired peritoneal (53%) or levator defects (79%).
  • Transperineal repair with simple closure or mesh was successful in most cases (19 repairs).
  • Recurrence rate was 16%, with wound infections being the primary complication.

Conclusions:

  • Primary closure of the perineal wound and meticulous infection control are vital for preventing perineal hernias.
  • Transperineal repair using simple closure or mesh demonstrates high success rates for existing hernias.