Low incidence of perineal hernia repair after abdominoperineal resection for rectal cancer.

INTRODUCTION Perineal hernia may be a long-term complication to conventional abdominoperineal resection or proctocolectomy. We analysed the incidence of post-operative perineal hernia repair and described patient-reported outcome measures (PROMS) after perineal hernia repair. METHODS This was a nationwide retrospective analysis of consecutive Danish patients undergoing conventional abdominoperineal resection or proctocolectomy for rectal cancer from 1 January 2004 to 31 December 2014 combined with patients undergoing a subsequent repair for a perineal hernia during the follow-up period from 1 January 2004 to 31 December 2016. Patients were sent a quality of life questionnaire (HerQles A) and related PROMS. RESULTS The incidence of perineal hernia repair was 0.83%. A total of 2,170 patients underwent proctocolectomy and conventional abdominoperineal resection, and 18 patients had a subsequent perineal hernia repair. Four patients developed a clinical hernia recurrence, another four patients reported moderate/severe perineal pain or heaviness during physical activity and complained of poor perception of health, and one patient reported that the perineal hernia repair had a negative impact on sexual function. CONCLUSIONS The incidence of perineal hernia repair was below 1% after conventional abdominoperineal resection and proctocolectomy. PROMS and risk of recurrence may benefit from centralising perineal hernia repair. FUNDING none. TRIAL REGISTRATION not relevant.