Is there a place for a biological mesh in perineal hernia repair?

Abstract

PURPOSE:

This study aimed to determine the outcome of perineal hernia repair with a biological mesh after abdominoperineal resection (APR).

METHOD:

All consecutive patients who underwent perineal hernia repair with a porcine acellular dermal mesh between 2010 and 2014 were included. Follow-up was performed by clinical examination and MRI.

RESULTS:

Fifteen patients underwent perineal hernia repair after a median of 25 months from APR. Four patients had a concomitant contaminated perineal defect, for which a gluteal fasciocutaneous flap was added in three patients. Wound infection occurred in three patients. After a median follow-up of 17 months (IQR 12-24), a clinically recurrent perineal hernia developed in 7 patients (47 %): 6 of 11 patients after a non-cross-linked mesh and 1 of 4 patients after a cross-linked mesh (p = 0.57). Routine MRI at a median of 17 months revealed a recurrent perineal hernia in 7 of 10 evaluable patients, with clinical confirmation of recurrence in 5 of these 7 patients. No recurrent hernia was observed in the three patients with combined flap reconstruction for contaminated perineal defects.

CONCLUSION:

A high recurrence rate was observed after biological mesh repair of a perineal hernia following APR.

• Authors: G D Musters, O Lapid, J Stoker, B F Musters, W A Bemelman, P J Tanis
• Journal: Hernia : the journal of hernias and abdominal wall surgery (Hernia) Vol. 20 Issue 5 Pg. 747-54 (Oct 2016) ISSN: 1248-9204 [Electronic] France
• PMID: 27240846 (Publication Type: Journal Article)

Topics

• Acellular Dermis
• Aged
• Animals
• Bioprosthesis
• Female
• Hernia, Abdominal (surgery)
• Herniorrhaphy (adverse effects, methods)
• Humans
• Male
• Middle Aged
• Perineum (surgery)
• Rectal Neoplasms (surgery)
• Recurrence
• Surgical Mesh