Mesh, flap or combined repair of perineal hernia after abdominoperineal resection – A systematic review and meta-analysis

Sarah Sharabiany, Thomas P.A. Brouwer, Saskia I. Kreisel, Gijsbert D. Musters, Robin D. Blok, Roel Hompes, Pieter J. Tanis*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

8 Citations (Scopus)
106 Downloads (Pure)


Aim: The aim of this systematic review was to analyse recurrence rates after different surgical techniques for perineal hernia repair. Method: All original studies (n ≥ 2 patients) reporting recurrence rates after perineal hernia repair after abdominoperineal resection (APR) were included. The electronic database PubMed was last searched in December 2021. The primary outcome was recurrent perineal hernia. A weighted average of the logit proportions was determined by the use of the generic inverse variance method and random effects model. Results: A total of 19 studies involving 172 patients were included. The mean age of patients was 64 ± 5.6 years and the indication for APR was predominantly cancer (99%, 170/172). The pooled percentage of recurrent perineal hernia was 39% (95% CI: 27%–52%) after biological mesh closure, 29% (95% CI: 21%–39%) after synthetic mesh closure, 37% (95% CI: 14%–67%) after tissue flap reconstruction only and 9% (95% CI: 1%–45%) after tissue flap reconstruction combined with mesh. Conclusion: Recurrence rates after mesh repair of perineal hernia are high, without a clear difference between biological and synthetic meshes. The addition of a tissue flap to mesh repair seemed to have a favourable outcome, which warrants further investigation.

Original languageEnglish
Pages (from-to)1285-1294
Number of pages10
JournalColorectal Disease
Issue number11
Early online date16 Jun 2022
Publication statusPublished - Nov 2022

Bibliographical note

Publisher Copyright:
© 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.


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