Repair of a Huge Incisional Hernia with Sigmoid Colon Cancer Ileus by the Component Separation Method—A Case Report—

Abstract

In incisional hernia repair, reconstruction using an artificial material is not indicated because of the risk of infection in surgery involving surgical field contamination. A case of a huge incisional hernia with ileus caused by sigmoid colon cancer, which was reconstructed by tumor resection and component separation, is presented. A 55-year-old man was transported by the emergency services because of difficulty moving. Computed tomography showed ileus due to sigmoid cancer and a huge incisional hernia, 21 cm in length and 15 cm in width, in the upper abdomen, and the dilated intestinal tract had escaped. Decompression was performed by an intestinal stent, but 11 days later, abscess formation occurred due to stent occlusion and retroperitoneal penetration, so semi-emergency surgery was performed. Tumor resection by Hartmann's procedure and abdominal wall reconstruction by the component separation method were performed. A stoma was created in the lower left abdomen, and it was possible to close the wound while maintaining the strength of the abdominal wall. The wound was treated with negative pressure wound therapy, and the patient was discharged without complications.