Abstract
A 57-year-old man underwent laparoscopic abdomino-perineal resection with curative intent for rectal cancer. The pathological diagnosis of the tumor was mucinous adenocarcinoma. The patient underwent post-operative adjuvant chemotherapy after he was classified into the high risk group. About 8 months after the surgery, he complained of a perineal swelling making him difficult to sit down. Physical examination revealed a fist-sized bulge in the perineal region. An abdominal CT scan revealed a small bowel protruding through the pelvic floor. We made the diagnosis of secondary perineal hernia and performed a hernia repair with ULTRAPRO®PLUG and ULTRAPRO®MESH by the transperineal approach. The postoperative course of the patient was uneventful and he was discharged on the 4th day after the hernioplasty. It is 1 year and 8 months since he underwent the operation, and no recurrence has been observed so far. Secondary perineal hernia is a rare disease after abdomino-perineal resection or pelvic surgery. We found 17 cases of secondary perineal hernia reported in Japan including our case. We review these cases and discuss the clinical features, causes and therapies of the disease.
