Laparoscopic perineal hernia repair after abdominoperineal resection.

Abstract

<h4>Purpose</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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%.<h4>Conclusion</h4>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.