The management of perineal hernia following abdomino-perineal excision for cancer

Autor: M Luong, Najim Chafai, Thibault Voron, Ben Creavin, K Bertrand, Emmanuel Tiret, Yann Parc, Jérémie H. Lefevre, Clotilde Debove
Přispěvatelé: Service de chirurgie générale et digestive [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
MESH: Carcinoma
Hernia
Colorectal cancer
[SDV]Life Sciences [q-bio]
030230 surgery
MESH: Surgical Mesh
Perineum
Surgical Flaps
0302 clinical medicine
MESH: Aged
80 and over
Recurrence
Abdomen
Rectal cancer
Perineal hernia
Aged
80 and over
MESH: Aged
Proctectomy
MESH: Middle Aged
Middle Aged
3. Good health
030220 oncology & carcinogenesis
Cohort
Female
MESH: Neoplasm Recurrence
Local
Abdomino-perineal resection
Adult
medicine.medical_specialty
MESH: Abdomen
Resection
03 medical and health sciences
medicine
MESH: Herniorrhaphy
Humans
MESH: Perineum
Herniorrhaphy
Aged
Retrospective Studies
MESH: Humans
Rectal Neoplasms
business.industry
MESH: Proctectomy
Carcinoma
Cancer
MESH: Rectal Neoplasms
MESH: Adult
MESH: Retrospective Studies
Surgical Mesh
MESH: Surgical Flaps
medicine.disease
MESH: Hernia
Combined approach
MESH: Male
Surgery
MESH: Recurrence
Neoplasm Recurrence
Local
business
Complication
MESH: Female
Abdominal surgery
Zdroj: Hernia
Hernia, Springer Verlag, 2020, 24 (2), pp.279-286. ⟨10.1007/s10029-019-01927-7⟩
ISSN: 1265-4906
1248-9204
Popis: International audience; Purpose: Perineal hernia (PH) is a tardive complication following abdomino-perineal resection (APR). Many repair methods are described and evidences are lacking. The aim of this study was to report PH management, analyze surgery outcomes and review the available literature.Methods: We retrospectively included all consecutive PH repair after APR performed between 2001 and 2017. We recorded data on APR surgery, PH symptoms and repair, and follow-up (recurrence and morbidity). Literature review included published articles on PubMed between 1960 and 2017.Results: 24 PH repairs were included. The approach was perineal N = 16, abdominal N = 5 and combined N = 3. A biological mesh was used for 17, a synthetic for 5 and a flap for 2 patients. The median follow-up was 25 months. Overall morbidity was 37.5% (N = 9): 37.5% for the perineal, 20% for the abdominal, and 66.7% for the combined approach. Complications occurred in 35.3% of biological and 20% of synthetic mesh repairs. Recurrence rate was 41.7%, similar for biological (n = 8, 47.1%) and synthetic meshs (n = 2; 40%). No recurrence occurred in the flap group. Depending of the approach, we found 50% for perineal (n = 8) and 40% of the abdominal cohort (N = 2). Among twelve studies, recurrence rates ranged from 0 to 66.7%. Abdominal or laparoscopic approach with synthetic mesh was associated with less recurrences (0 and 12.5% respectively) and complications (37.5% and 9.5%).Conclusions: Recurrences following PH repair are high irrespective of the repair technique. More studies are necessary to identify PH risk factors and decide the appropriate perineal reconstruction.
Databáze: OpenAIRE
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