Caudal protrusion of pelvic organs and dilatation and deviation of the rectum with perineal hernia (PH) have not previously been studied using CT, and it is not known how completely the changes normalize after PH repair. Objectives of this prospective experimental case series were to evaluate the dimensions and shape of the rectum and the volume, location, and other features (enhancement pattern, presence of cysts, and mineralizations) of the prostate of 66 dogs on CT before and 3 months after PH repair. The rectal cross-sectional areas were measured at intrapelvic and caudal locations, and the shape was categorized as straight, deviated, flexure, or caudal fold on dorsal images. According to paired samples t-tests, the caudal rectal dimensions were significantly larger (P < .001) than the intrapelvic dimensions both before and 3 months after PH repair, and according to linear mixed models, the intrapelvic dimensions increased significantly (P < .001) after repair. Before PH repair, the most common rectal shape was flexure (69.2%); after repair, the number of dogs having a straight rectum increased significantly (P < .001) according to the McNemar paired-samples proportion test. We were also able to show that rectal dimensions increased after PH repair despite straightening in most dogs. According to the linear mixed model, prostate ratio volume, and according to Wilcoxon signed ranks test, the number of prostates with intraprostatic cysts decreased significantly (both P < .001) after PH repair, but the proportion of prostates located in the caudal or perineal area did not. Small mineralizations remained in some dogs.
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http://dx.doi.org/10.1111/vru.13341 | DOI Listing |
Tech Coloproctol
December 2024
Department of General Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Background: Abdominoperineal resection (APR) is the standard treatment for locally advanced distal rectal cancer (LADRC) following neoadjuvant treatment when sphincter-preserving procedures are inapplicable. However, complications such as perineal site infection, perineal hernia and postoperative ileus remain ongoing challenges. We aimed to compare the rate of postoperative ileus due to pelvic incarceration in APR patients with/without pelvic inlet closure.
View Article and Find Full Text PDFJ Abdom Wall Surg
November 2024
Department of General Surgery, University of Missouri, Columbia, MO, United States.
Introduction: Perineal hernias, protrusions through the pelvic diaphragm, are a rare complication post-abdominoperineal resection. The shift to extralevator APR techniques could be linked to a potential increase in these hernias. This case series evaluates the surgical management of perineal hernias, focusing on the evolving role of robotic surgery.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Digestive Surgery Service, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), 1000 rue St-Denis, Montreal, QC H2X 0C1, Canada.
Perineal hernias occur rarely following abdominoperineal resections. No standardized surgical approach exists for treating PH. We herein present the case of a large, symptomatic PH that was repaired with a combined abdominal and perineal approach, with peritoneal flap reconstruction of the pelvic floor and placement of a biological mesh.
View Article and Find Full Text PDFJ Abdom Wall Surg
November 2024
Department of General Surgery, ASST Nord Milano, Milano, Italy.
Background: Postoperative perineal hernia (PH) is an uncommon complication after abdominoperineal resection (APR). Different techniques have been described in literature and there is no consensus regarding the optimal repair approach. In the present study, we reported a case of a laparoscopic combined repair of a perineal hernia and abdominal parastomal hernia (PSH) with mesh.
View Article and Find Full Text PDFPurpose: The purpose of this study is to systematically review the literature to evaluate the diagnostic methods, associated defects, treatment approaches, and outcomes of congenital perineal hernia.
Methods & Results: We searched PubMed and Google Scholar from inception until January 7, 2024, to find relevant articles on congenital perineal hernia. A total of 87 articles were obtained which were screened based on eligibility criteria yielding a total of 12 documented cases that were summarized in a table.
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