Suwa Katsuhito, Kurogochi Takanori, Ushigome Takuro, Enomoto Hiroya, Okamoto Tomoyoshi, Eto Ken
Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan.
Department of Surgery, The Jikei University Hospital, Tokyo, Japan.
J Anus Rectum Colon. 2023 Oct 25;7(4):301-306. doi: 10.23922/jarc.2023-011. eCollection 2023.
The aim of this study was to evaluate the effectiveness of transperineal repair of secondary perineal hernia (SPH) using a mesh with a memory-recoil ring.
Seven patients with SPH who underwent transperineal repair (TPR) between July 2010 and May 2022 were retrospectively analyzed. TPR was performed using a mesh with a memory-recoil ring.
All SPHs developed after abdominoperineal resections in patients with anorectal malignancies. The median longitudinal and transverse diameters of the hernia orifice were 8 (7-10) cm and 6 (5-7) cm, respectively. In all cases, the mesh was fixed to the ischial tuberosity, residual levator muscle, coccygeus muscle, and coccyx after thorough dissection of the sac. The median operation time was 154 (142-280) min. Perioperative complications occurred in 2 cases (29%). One was enterotomy, which caused postoperative mesh infection requiring extraction of the mesh. The other was vaginal injury, which resulted in vaginal fistula but closed spontaneously. The median postoperative length of stay was 9 (5-14) days. No recurrence was observed during a median follow-up of 35 (9-151) months.
TPR using a mesh with a memory-recoil ring is safe, feasible and promising technique for SPH repairs.
本研究旨在评估使用带记忆回弹环的补片经会阴修补继发性会阴疝（SPH）的有效性。
回顾性分析2010年7月至2022年5月期间接受经会阴修补术（TPR）的7例SPH患者。TPR采用带记忆回弹环的补片进行。
所有SPH均发生于肛管直肠恶性肿瘤患者的腹会阴切除术后。疝孔的纵向和横向直径中位数分别为8（7 - 10）cm和6（5 - 7）cm。所有病例中，在彻底解剖疝囊后，将补片固定于坐骨结节、耻骨直肠肌残端、尾骨肌和尾骨。中位手术时间为154（142 - 280）分钟。围手术期并发症发生2例（29%）。1例为肠切开术，导致术后补片感染，需取出补片。另1例为阴道损伤，导致阴道瘘，但自行愈合。术后中位住院时间为9（5 - 14）天。中位随访35（9 - 151）个月期间未观察到复发。
使用带记忆回弹环的补片进行TPR是一种安全、可行且有前景的SPH修补技术。
