ArticleSurgical endoscopy2021
The impact of laparoscopic technique on the rate of perineal hernia after abdominoperineal resection of the rectum.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Minimally invasive versus open abdominoperineal resection and the risk of postoperative perineal hernia: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2026Pooled it
- Meta-analysis of biological mesh reconstruction versus primary perineal closure after abdominoperineal excision of rectal cancer.International journal of colorectal disease · 2021Pooled it
- Safety and Efficacy of Pelvic Reinforcement Procedure for Preventing Postoperative Perineal Hernia After Robotic Abdominoperineal Resection: A Single-Center, Retrospective Cohort Study.Annals of gastroenterological surgery · 2026Article
- Early Complication Differences Between Laparoscopic and Open Abdominoperineal Resection.Cureus · 2025Article
- Incidence and risk factors for perineal hernia after robotic abdominoperineal resection: a single-center, retrospective cohort study.Techniques in coloproctology · 2024Article
- Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn's disease.Radiology case reports · 2023Article
- Advantages of robotic abdominoperineal resection compared with laparoscopic surgery: a single-center retrospective study.Surgery today · 2022Article
- Transanal total mesorectal excision port-assisted perineal hernia repair: A case report.Frontiers in oncology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo determine the impact of surgical technique on the incidence of perineal hernia after abdominoperineal resection (APR).
methodsA retrospective analysis was performed on patients who underwent APR between May 2007 and March 2018 at our institution using our prospectively maintained Colorectal Cancer Database. Demographic and clinical parameters were compared between the open APR (OAPR) and laparoscopic APR (LAPR) groups using Student's t test, chi-squared, or Fisher's exact test. Putative risk factors were then analyzed using a Cox proportional hazard model with perineal hernia as the outcome.
resultsThe study included 261 patients (191 OAPR and 70 LAPR). Intraoperative blood loss (596.0 ± 633.4 vs. 307.0 ± 307.2 mL, p < 0.001), duration of OR (249.6 ± 115.6 vs. 212.6 ± 75.1 min, p = 0.004), and length of stay (15.6 ± 18.0 vs. 10.4 ± 12.6 days, p = 0.031) were all greater for OAPR than LAPR patients, but wound complications other than hernia did not differ significantly. Perineal hernia was observed in 2.1% of OAPR and 12.9% of LAPR patients. In multivariable analysis, significant risk factors for perineal hernia were age, laparoscopic technique, and closure of the perineal wound with myocutaneous flap (HR 1.08, 11.13, and 31.51, respectively, all p < 0.05).
conclusionsLAPR, although associated with less blood loss and shorter length of hospital stay than OAPR, was a significant risk factor for perineal hernia.
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