Surgical treatment of postoperative perineal hernias (a literature review)

The purpose of the study: to review surgical methods for the treatment of rectal cancer, as well as inflammatory bowel diseases involving the rectum. Materials and methods. According to literature data, a perineal hernia forms in the period from 4 to 14 months after surgical treatment. In a number of patients, the postoperative period after total proctectomy in radical interventions is accompanied by the formation of a perineal hernia, which, in addition to anatomical changes, is manifested by chronic pain syndrome, impaired functions of the genitourinary system, and skin changes. Results. Timely diagnosis and detection of these pathological changes are necessary not only to improve the quality of life, but also to prevent potential emergencies, since, like other types of hernias, perineal hernias can lead to serious complications. Currently, there is no generally accepted standard of treatment for postoperative perineal hernias. Surgical intervention remains the only radical method, which necessitates the evaluation of the effectiveness of various surgical techniques, as well as the development of indications for the employment of each of them. Conclusion. The recurrence rate after perineal hernia repair remains high, regardless of the technique used. The greatest risk is noted with the use of biological meshes, while synthetic meshes show slightly better results, especially with abdominal and laparoscopic access, which is also associated with the lowest incidence of complications. Reconstruction of the pelvic floor with musculoskeletal flaps has shown the most encouraging results, completely eliminating relapses, which makes this method promising.