ArticleHernia : the journal of hernias and abdominal wall surgery2026
Perineal hernia following extra-levator abdominoperineal resection: prevalence, associated risk factors and types of perineal closure. a single-centre descriptive study.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePrimary aim was to analyse the incidence of perineal hernia (PH) after elective extra-levator abdominoperineal resection (ELAPE), comparing pelvic floor closure techniques. Secondary aim was to assess postoperative wound complications and associated risk factors.
methodsA retrospective, descriptive, single-centre study (2017–2023), was conducted on consecutive patients undergoing elective ELAPE.
resultsFifty-seven patients were included. Direct closure or myocutaneous flap was performed in 31.6% (18 patients) and mesh reinforcement in 68.4% [39 patients – 34 double-component, 3 biological, 2 non-specified material –]. No differences referred to PH prevalence were found comparing the closure techniques, except higher additional organ resection in the direct group – 2 patients versus no patients in the mesh group (p 0.034) –. PH incidence was 3.5% (2 patients): one patient from the direct group and one patient from the mesh group (p 0.584). Only one patient required PH repair. Perineal wound (PW) complications accounted for 38.9% (7 patients) in the direct closure and 25.6% (10 patients) in the mesh group. The only myocutaneous flap case developed PW dehiscence. No differences in PW complications were observed regarding type of radiotherapy (long-term versus short-term) (p 0.248). Median follow-up was 51.9 months: 62.4 months in the mesh group versus 36.7 months in the direct closure group.
conclusionIn our study, the use of mesh reinforcement in ELAPE to prevent PH did not demonstrate superiority over pelvic floor direct closure. However, a tendency toward a higher risk of PW complications in the direct closure group was observed.
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