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Session: ePoster Monitor 6-Rectal Cancer 5

eP685 - Perineal Hernia After Abdominoperineal Resection, a Real Pain in the …

Monday, June 3, 2024
1:39 PM – 1:44 PM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Tiahna Spencer, MD

    General Surgery Resident
    Inova
    Inova Health
    Fairfax, VA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • TP

    Timothy Plerhoples, MD

    Private Practice Surgeon
    Fairfax Colon and Rectal Surgery
    Fairfax, Virginia, United States

    Disclosure information not submitted.

Purpose/Background: Perineal hernias after abdominoperineal resection occur in only < 1% of cases, but often contribute to poor patient quality of life and challenging repair options. Notable risk factors include preoperative chemo-radiation, smoking and post-operative wound infection. Repair options include open transperitoneal, transabdominal or laparoscopic repairs with mesh. We herein report a case of a 59-year-old male who presented with perineal hernia 5 years after his APR for rectal cancer.Methods/Interventions: Review of case notes.Results/Outcomes: 59-year-old male with rectal cancer status post laparoscopic assisted abdominoperineal resection with partial prostatectomy and urethroplasty who presents 5 years postoperatively with a perineal hernia found on routine imaging. On a MRI of his pelvis, it was found that he had a small bowel containing perineal hernia. The patient was at increased risk secondary to requiring preoperative chemo-radiation due to extent of his rectal cancer, as well as chronic smoking. In combination with plastic surgery, the patient underwent a perineal hernia repair with synthetic mesh, gracilis flaps and sub-fascial implantation of calcium sulfate delivery device. The patient tolerated the procedure well and was discharged home post-operative day one.Conclusion/

Discussion: Despite their low occurrence the literature has shown an increase of perineal hernias with the adoption of a laparoscopic approach. Given the challenging repair we report this case to underlie the importance for awareness and a possible benefit from a multidisciplinary approach with plastic surgery."MRI Pelvis

Small bowel containing perineal hernia
CT chest, abdomen and pelvis

Small bowel containing perineal hernia"