Bocková M, Hoch J, Frajer L
Rozhl Chir. 2016 Spring;95(5):206-9.
Perineal hernia is defined as a protrusion of intra-abdominal viscera through a defect in the pelvic floor. Primary hernias are extremely rare; secondary (postoperative) hernias following pelvic surgery, especially abdominoperineal resection or pelvic exenteration, are more common. Impaired perineal wound healing and neoadjuvant chemoradiotherapy in cancer patients are defined as main risk factors. A growing incidence of this complication is expected in connection with an increasing use of laparoscopic approaches and ELAPE. Despite the considerable time since the first described secondary perineal hernia in literature, patient series, prospective studies and treatment guidelines are still missing. The authors present a case of a 66-year-old man with secondary perineal hernia following a previous laparoscopic abdominoperineal resection for rectal cancer undergoing a surgical intervention. This was performed through an abdominal approach using a rectus abdominis muscle flap to repair the pelvic floor defect.
perineal hernia - hedrocele - RAM - abdominoperineal resection.
会阴疝被定义为腹腔内脏器通过盆底缺损突出。原发性疝极为罕见;盆腔手术后的继发性(术后)疝,尤其是腹会阴联合切除术或盆腔脏器清除术后的疝更为常见。癌症患者会阴伤口愈合受损和新辅助放化疗被确定为主要危险因素。随着腹腔镜手术方法和扩大经肛全直肠系膜切除术(ELAPE)的使用增加,预计这种并发症的发生率会上升。尽管自文献首次描述继发性会阴疝以来已有相当长的时间,但患者系列研究、前瞻性研究和治疗指南仍然缺失。作者报告了一例66岁男性患者,该患者此前因直肠癌接受腹腔镜腹会阴联合切除术后发生继发性会阴疝,现正接受手术干预。手术通过腹部入路,使用腹直肌肌瓣修复盆底缺损。
会阴疝 - 疝 - 腹直肌肌瓣 - 腹会阴联合切除术