Experience in the treatment of a patient with postoperative perineal hernia after extended combined abdominal-perineal extirpation of the rectum

Improvements in surgical techniques have made it possible to perform extended surgical interventions for rectal cancer and achieve good treatment results for patients with this pathology, but have led to an increase in complications in the form of the formation of postoperative perineal hernias. The anatomical features of the perineum and postoperative tissue changes create significant difficulties in choosing a method of surgical treatment.

This article presents a rare clinical case of surgical treatment of a patient with a postoperative perineal hernia. After a preoperative examination, the patient was operated on in the Surgical Department of the Hospital Surgery Clinic of Clinics of Samara State Medical University. The patient underwent pelvic floor replacement with a mesh implant. The complexity of the clinical case consisted of a deficiency of myofascial structures in the plastic area, limited fixation points for the mesh implant, the presence of a severe concomitant disease in the form of type II diabetes mellitus, and the patient’s advanced age.

The surgical treatment performed allowed us to achieve good treatment results and significantly improve the patient’s quality of life, preventing the development of life-threatening complications.

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