Perineal hernia after laparoscopic abdominoperineal resection : Report of two cases Yusuke MUNEOKA 1 , Atsushi NISHIMURA 1 , Shigeto MAKINO 1 , Mikako KAWAHARA 1 , Chie KITAMI 1 , Takuma OKAMURA 1 1Department of Surgery, Institute of Gastroenterology, Nagaoka Chuo General Hospital Keyword: 続発性会陰ヘルニア・腹腔鏡下腹会陰式直腸切断術・Dual Mesh® pp.549-554
Published Date 2013/9/15
DOI https://doi.org/10.11477/mf.4426100987
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Perineal hernias are rare secondary disorders. Here, we report two cases of hernia that developed after laparoscopic abdominoperineal resection(APR) for rectal cancer. Both patients noticed bulges at the perineal region at three and four months after APR respectively. For each patient, the diagnosis of a perineal hernia was made based on the symptoms and CT findings. We performed an operation for one patient to repaire the hernia using Dual Mesh® via the perineum with no difficulty. Perineal approach was useful for this case because no adhesions were observed around the hernia orifice. Another patient was observed without operation. We speculate that perineal hernia that developed after laparoscopic APR is caused by fewer postoperative adhesions and omission of repairing the pelvic peritoneum. So, we must take pelvic peritoneal repair into consideration in patients with extra long mesenterium or post-total hysterectomy cases.

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