Mesh, flap or combined repair of perineal hernia after abdominoperineal resection - A systematic review and meta-analysis.

Abstract

AIM:

The aim of this systematic review was to analyse recurrence rates after different surgical techniques for perineal hernia repair.

METHOD:

All original studies (n ≥ 2 patients) reporting recurrence rates after perineal hernia repair after abdominoperineal resection (APR) were included. The electronic database PubMed was last searched in December 2021. The primary outcome was recurrent perineal hernia. A weighted average of the logit proportions was determined by the use of the generic inverse variance method and random effects model.

RESULTS:

A total of 19 studies involving 172 patients were included. The mean age of patients was 64 ± 5.6 years and the indication for APR was predominantly cancer (99%, 170/172). The pooled percentage of recurrent perineal hernia was 39% (95% CI: 27%-52%) after biological mesh closure, 29% (95% CI: 21%-39%) after synthetic mesh closure, 37% (95% CI: 14%-67%) after tissue flap reconstruction only and 9% (95% CI: 1%-45%) after tissue flap reconstruction combined with mesh.

CONCLUSION:

Recurrence rates after mesh repair of perineal hernia are high, without a clear difference between biological and synthetic meshes. The addition of a tissue flap to mesh repair seemed to have a favourable outcome, which warrants further investigation.

• Authors: Sarah Sharabiany, Thomas P A Brouwer, Saskia I Kreisel, Gijsbert D Musters, Robin D Blok, Roel Hompes, Pieter J Tanis
• Journal: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (Colorectal Dis) Vol. 24 Issue 11 Pg. 1285-1294 (11 2022) ISSN: 1463-1318 [Electronic] England
• PMID: 35712806 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

Topics

• Aged
• Humans
• Middle Aged
• Hernia, Abdominal (etiology, surgery)
• Herniorrhaphy (methods)
• Perineum (surgery)
• Proctectomy (adverse effects)
• Surgical Mesh
• Free Tissue Flaps
• Recurrence
• Neoplasms (surgery)