Our Summary

This study looks at cases of perineal hernia, which is when parts of the gut push through a weak spot in the lower part of the belly and into the perineum (the area between the genitals and the anus). This is a complication that can happen after a specific type of surgery (abdominoperineal resection) for rectal cancer.

The researchers looked at 30 cases, using data from 24 published articles. They looked at things like the patients’ age and sex, how long it had been since their surgery, how the hernia showed up, how it was treated, and any complications.

The people in the study were on average 71.5 years old, and there were slightly more men than women. The hernias showed up anywhere from 6 days to 12 years after surgery. The main symptom was a painful lump in the perineum, but some people also had a blocked gut.

The researchers found that perineal hernias are being reported more and more as a complication of this type of surgery, especially as the techniques used for rectal cancer surgery have become less invasive. They recommend that doctors should be aware of this and look for it during follow-up appointments after surgery. The hernias were treated with surgery, but the best method depended on the individual patient.

FAQs

  1. What is a perineal hernia and when can it occur?
  2. What were the main findings of this study on perineal hernias after abdominoperineal resection for rectal cancer?
  3. How are perineal hernias treated according to the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about proctectomy is to make sure to follow post-operative care instructions closely to help prevent complications such as perineal hernias. This may include avoiding heavy lifting, maintaining proper hygiene in the perineal area, and attending follow-up appointments with your healthcare provider. If you notice any new or worsening symptoms, such as a painful lump in the perineum, be sure to report them to your doctor promptly. Early detection and treatment of complications can help improve outcomes and overall recovery.

Suitable For

Patients who have undergone abdominoperineal resection for rectal cancer are typically recommended proctectomy if they develop perineal hernias as a complication. These patients are usually older, with an average age of 71.5 years, and may experience symptoms such as a painful lump in the perineum or a blocked gut. It is important for doctors to be aware of the possibility of perineal hernias developing after surgery and to monitor patients closely during follow-up appointments. Treatment for perineal hernias typically involves surgery, but the best method of treatment varies depending on the individual patient.

Timeline

Before proctectomy, a patient may undergo tests such as colonoscopy and imaging studies to diagnose the condition requiring surgery. They may also receive preoperative counseling and instructions on how to prepare for the procedure, such as bowel preparation.

During proctectomy, the diseased portion of the rectum or colon is removed, and the remaining healthy tissue is reconnected. The surgery may be performed through an open incision or minimally invasive techniques such as laparoscopy or robotic surgery.

After proctectomy, the patient will typically spend several days in the hospital for monitoring and recovery. They may experience pain, discomfort, and changes in bowel function as they recover. The healthcare team will provide instructions on wound care, diet, medications, and activity restrictions to promote healing.

In the months following proctectomy, the patient will have follow-up appointments with their healthcare provider to monitor their progress and address any complications or concerns. They may also undergo additional tests such as colonoscopy to check for recurrence of the disease.

Overall, the timeline of a patient’s experience before and after proctectomy involves preoperative preparation, surgery, hospitalization, recovery, and long-term follow-up care to ensure optimal outcomes.

What to Ask Your Doctor

  1. What is a proctectomy and why is it recommended for me?
  2. What are the potential risks and complications associated with proctectomy surgery?
  3. How will my recovery process look like after the surgery?
  4. What kind of follow-up care will I need after the proctectomy?
  5. How likely am I to develop perineal hernia after the surgery?
  6. What are the symptoms of perineal hernia and how can it be diagnosed?
  7. What are the treatment options for perineal hernia if it occurs?
  8. How can I prevent perineal hernia or minimize my risk of developing it?
  9. Are there any lifestyle changes or restrictions I need to follow after the proctectomy to reduce my risk of complications?
  10. Are there any support groups or resources available for patients who have undergone a proctectomy surgery?

Reference

Authors: Salati SA, Arkoubi AY. Journal: Pol Przegl Chir. 2022 Apr 7;94(6):61-70. doi: 10.5604/01.3001.0015.7677. PMID: 36468514