ObjectiveTo summarize the surgical experience of perineal hernia (PH) repairment after a laparoscopic abdominoperineal resection (APR) with synthetic mesh.MethodsThe clinical data of 4 cases of PH after APR from 2009 to 2015 underwent surgery were analyzed retrospectively. We applied synthetic mesh for the reconstruction of the pelvic floor.ResultsAll of the 4 cases recovered smoothly, with no complication happened. The blood loss during the operation was 50–100 mL, the operative time was 1.0–1.5 hours, the postoperative time of getting out of bed was delayed to 5–7 days after the operation and discharged after 10–14 days. Patients were advised to use transperineal bandages or rigid underpants to lift up the perineum to reduce tension after discharge. No recurrence of perineal hernia or the tumor was found on physical examination and abdominal pelvic CT scan during the 24-month follow-up.ConclusionsIt brings better effect and less trauma after the operation by using transperineal repair of PH with synthetic mesh. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.
ObjectiveTo systematically evaluate the effects of biological mesh (BM) and non-absorbable synthetic mesh (SM) on the risks of recurrence, complications, and cost-effectiveness after ventral hernia repair. MethodsThe publicly published related researches of BM versus SM for ventral hernia repair were searched in the PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, CBM databases from the establishment of the databases to August 1, 2021. According to the inclusion and exclusion criteria, the literatures were screened and the data were extracted, and the data that met the conditions were merged and analyzed. The meta-analysis was performed by RevMan5.4.1 software. ResultsA total of 26 studies with 3 259 patients were included, including 1 388 patients in the BM group and 1 871 in the SM group. The results of meta-analysis showed that the recurrence, surgical site infection, surgical site occurrence, reoperation rates, and medical costs in the BM group were higher than those in the SM group (P<0.05). There were no significant differences in the patch infection, seroma, hematoma, wound dehiscence, and readmission rates between the two groups (P>0.05). ConclusionsSM during ventral hernia repair is better than BM on postoperative recurrence, surgical site infection, surgical site occurrence, reoperation, etc., and could reduce medical costs. In the future, it is tried to use more SM in patients with complicated ventral hernia such as cleaning pollution and contaminated environment.