scholarly journals A Perineal Hernia following Rectal Resection Successfully Repaired by the Combined Use of Laparoscopy and a Gluteal Fold Flap

Author(s):  
Ryohei ONISHI ◽  
Hisahiro HOSOGI ◽  
Shota TUKASAKI ◽  
Hidero YOSHIMOTO ◽  
Akinari NOMURA ◽  
...  
2015 ◽  
Vol 3 (10) ◽  
pp. e541 ◽  
Author(s):  
Masahide Fujiki ◽  
Shimpei Miyamoto ◽  
Masaki Arikawa ◽  
Minoru Sakuraba

2021 ◽  
Author(s):  
Jing Wen ◽  
Jian Shen ◽  
Qiushi Huang ◽  
Shan He

Abstract Background: Laparoscopic rectal resection may cause various surgical complications including perineal hernia and adhesive small-bowel obstruction. Pelvic peritoneum reconstruction (PPR) could prevent those complications. The aim of the study is to evaluate the short-term clinical, technical and safety outcomes of PPR using the barbed suture in laparoscopic rectal resection. Methods: This is a retrospective cohort study conducted in Chengdu second’s people hospital. Between January 2014 and December 2019, a total of 402 patients who underwent curative surgery for rectal cancer in Chengdu Second People’s Hospital were enrolled in the study. Among them, 216 patients who underwent laparoscopic rectal resection with PPR were allocated into the experimental group, and 186 patients who underwent laparoscopic rectal resection without PPR were allocated into control group. All the patients received standard preoperative and postoperative treatments. Observational indicators (1) surgical and postoperative conditions; (2) postoperative pathological examination. (3) postoperative complications. The data were represented by X ± s. t-test and X2 test were used for counting data. Results (1) Surgery condition: all patients in the two groups underwent successful surgery without conversion to open surgery. There were no differences between the two groups in terms of surgical approach, resection margin, tumor size, postoperative T-stage, postoperative N-stage, positive lymph nodes, harvest lymph nodes, perineal wound infection, perineal hernia, postoperative pneumonia, postoperative hemorrhage, presacral fluid, or abscess. The operative time, blood loss, the incidence of anastomotic leakage, and small-bowel obstruction showed a significant difference between the two groups. Conclusion We hypothesized that pelvic peritoneum reconstruction with barbed suture could improve the efficiency of intracorporeal closure of the pelvic cavity after in laparoscopic rectal resection, which can significantly reduce postoperative perineal-related complications. Further, we expect that use of the barbed sutures will reduce intra-operative stress on the endoscopic surgeon.


2016 ◽  
Vol 98 (04) ◽  
pp. e62-e64
Author(s):  
PA Neumann ◽  
AS Mehdorn ◽  
G Puehse ◽  
N Senninger ◽  
E Rijcken

Secondary perineal herniation of intraperitoneal contents represents a rare complication following procedures such as abdominoperineal rectal resection or cystectomy. We present a case of a perineal hernia formation with prolapse of an ileum neobladder following radical cystectomy and rectal resection for recurrent bladder cancer. Following consecutive resections in the anterior and posterior compartment of the lesser pelvis, the patient developed problems emptying his neobladder. Clinical examination and computed tomography revealed perineal herniation of his neobladder through the pelvic floor. Through a perineal approach, the hernial sac could be repositioned, and via a combination of absorbable and non-absorbable synthetic mesh grafts, the pelvic floor was stabilised. Follow-up review at one year after hernia fixation showed no signs of recurrence and no symptoms.In cases of extensive surgery in the lesser pelvis with associated weakness of the pelvic compartments, meshes should be considered for closure of the pelvic floor. Development of biological meshes with reduced risk of infection might be an interesting treatment option in these cases.


2017 ◽  
Vol 33 ◽  
pp. 107-111 ◽  
Author(s):  
Kurokawa Tomohiro ◽  
Giichiro Tsurita ◽  
Kentaro Yazawa ◽  
Masaru Shinozaki

2020 ◽  
Vol 24 (6) ◽  
pp. 593-597
Author(s):  
I. Westra ◽  
R. L. Huisinga ◽  
M. S. Dunker ◽  
O. Lapid ◽  
F. J. T. van Oosterom ◽  
...  

2021 ◽  
Vol 49 ◽  
Author(s):  
Yu. V. Ivanov ◽  
A. V. Smirnov ◽  
A. V. Vinokurov ◽  
A. I. Zlobin ◽  
V. R. Stankevich ◽  
...  

Aim: To evaluate the efficacy of mechanical bowel preparation (MBP) combined with oral antibacterials for the prevention of postoperative complications when preparing a patient for anterior rectal resection.Materials and methods: We analyzed shortterm results in 77 patients who had undergone anterior rectal resection for rectal and rectosigmoid junction cancer. Forty five (45) patients were prepared for surgery only with MBP. In 32 patients, in addition to MBP, oral antibacterial agents ciprofloxacin and metronidazole were used preoperatively.Results: The overall rate of postoperative complications was 6.25% (2/32 patients) in the group of combined preparation for surgery and 15.5% (7/45) in the group using only MBP. Surgical wound infection occurred in 1 patient in the combined preparation group and in 4 patients in the MBP only group. There was no anastomotic leak in the combined preparation group, whereas in the MBP only group, anastomotic leak occurred in 2 patients.Conclusion: Combined use of oral antibacterials and MBP before anterior rectal resection makes it possible to achieve an extremely low rate of the colorectal anastomosis leak. Further studies into the efficacy of this preparation regimen are needed, along with their discussion in the professional communities.


2009 ◽  
Vol 29 (04) ◽  
pp. 376-380 ◽  
Author(s):  
D. Capodanno ◽  
D. J. Angiolillo

SummaryDespite the clinical benefit associated with the combined use of aspirin and clopidogrel in patients with acute coronary syndrome or those undergoing percutaneous coronary intervention, a considerable interindividual variability in response to these drugs have been consistently reported. There is a growing interest on applying platelet functional tests with the goal of identifying patients at increased risk of recurrent ischaemic events and potentially tailoring antiplatelet treatment regimens.This manuscript will review the state of the art on the most commonly available platelet functional tests, describing their advantages and disadvantages and exploring their applicability in clinical practice.


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