Annals of Coloproctology

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Original Article

Complications

Incisional hernia risk in intracorporeal anastomosis with Pfannenstiel incision versus extracorporeal anastomosis with midline incision for laparoscopic right hemicolectomy: a multicenter comparison: Francesco Saverio Lucido, Giusiana Nesta, Luigi Brusciano, Claudio Gambardella, Francesco Pizza, Giuseppe Scognamiglio, Gianmattia del Genio, Salvatore Tolone, Federico Maria Mongardini, Massimo Mongardini, Ludovico Docimo, Simona Parisi; Ann Coloproctol. 2025;41(4):287-292. Published online June 18, 2025; DOI: https://doi.org/10.3393/ac.2024.00682.0097

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Abstract PDF: Purpose
Laparoscopic right hemicolectomy can be performed via intracorporeal ileocolic anastomosis (ICA) or extracorporeal ileocolic anastomosis (ECA). Prior studies have emphasized ICA’s advantages in hospital stay and postoperative pain. This multicenter study aimed to compare the 2-year incidence of incisional hernia between ICA (using a suprapubic Pfannenstiel incision) and ECA (using a pararectal incision) and assess perioperative outcomes.
Methods
We retrospectively analyzed patients undergoing laparoscopic right hemicolectomy between 2019 and 2020, divided into 2 groups: ICA with a Pfannenstiel incision and ECA with a pararectal incision.
Results
The mean operative time was longer in the ICA group (190 minutes vs. 170 minutes, P=0.004). Despite requiring advanced surgical skills and prolonged operative time, ICA was associated with superior short-term outcomes and a significantly lower incisional hernia rate compared to ECA (1.2% vs. 14.7%, P=0.044) at 24-month follow-up.
Conclusion
ICA is linked to longer operative times, but shorter hospital stays, fewer wound complications, and reduced incisional hernia rates compared to ECA.

Case Report

Benign bowel disease

Strangulated internal hernia through a defect of the broad ligament: a case report of laparoscopic surgery: Ji Hyeong Song, Jin Soo Kim; Ann Coloproctol. 2024;40(Suppl 1):S44-S47. Published online April 27, 2023; DOI: https://doi.org/10.3393/ac.2022.00906.0129

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2 Citations

Abstract PDF

An internal hernia is defined as the protrusion of an internal organ through a defect in the abdominal cavity. Broad ligament hernia (BLH) is an extremely rare type of internal hernia that is difficult to diagnose preoperatively because the symptoms are nonspecific. However, early diagnosis is crucial, and early surgery is required to reduce complications such as strangulation. Laparoscopy has the advantage of enabling simultaneous diagnosis and treatment of BLH. With the advancement of the laparoscopic techniques, several cases of laparoscopic treatment of BLH have been reported. Nevertheless, open surgery is primarily performed in patients requiring bowel resection. We present a case of laparoscopic surgery for a strangulated internal hernia through a broad ligament defect. We successfully resected the strangulated small intestine and closed the defect of the broad ligament laparoscopically with a minor incision.

Citations

Citations to this article as recorded by

Broad ligament defect causing internal hernia: A case report and literature review
Jie He, Yan Wen, Banzhu Zhang, Jun Zhou, Yuan Lin
Medicine.2025; 104(43): e45264. CrossRef
Inflamed Appendix Protruding Through a Right Broad Ligament Defect: A Case Report
Elissavet Symeonidou, Ioannis Gkoutziotis, Maria S SidiropouIou, Chrysoula Gouta , Kalliopi Gianna , Konstantinos Mpallas
Cureus.2024;[Epub] CrossRef

Original Article

Benign bowel disease

Risk factors of incisional hernia at the umbilical specimen extraction site in patients with laparoscopic colorectal cancer surgery: Masatsugu Hiraki, Toshiya Tanaka, Shinya Azama, Eiji Sadashima, Hirofumi Sato, Shuusuke Miyake, Kenji Kitahara; Ann Coloproctol. 2024;40(2):136-144. Published online June 21, 2022; DOI: https://doi.org/10.3393/ac.2022.00213.0030

7,576 View
209 Download
7 Web of Science
9 Citations

Graphical Abstract Abstract PDF

Purpose
Incisional hernia (IH) is a frequent complication following laparoscopic colorectal surgery. The present study investigated the risk factors for IH after laparoscopic surgery for colorectal cancer.
Methods
A retrospective study was conducted on 202 patients who underwent laparoscopic surgery for colorectal cancer. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with IH.
Results
The overall incidence of IH was 25.7% (52 of 202). The univariate analysis showed that female sex (P=0.004), a high body mass index (P<0.001), noncurrent smoking habit (P=0.043), low level of hemoglobin (P=0.035), high subcutaneous fat area (P<0.001), high visceral fat area (P=0.006), low skeletal muscle area (P=0.001), long distance between the inner edges of the rectus abdominis muscle (P=0.001), long protrusion of the peritoneum at the umbilical site (P<0.001), and lymph node metastasis (P=0.007) were significantly more frequent in the group with IH than in the group without it. The multivariate logistic regression analysis revealed an older age (10-year increments: odds ratio [OR], 1.576; 95% confidence interval [CI], 1.027–2.419; P=0.037), lymph node metastasis (OR, 2.384; 95% CI, 1.132–5.018; P=0.022) and lengthy protrusion of the peritoneum at the umbilical site (10-mm increments: OR, 5.555; 95% CI, 3.058–10.091; P<0.001) were independent risk factors for IH.
Conclusion
Our findings suggest that older age, lymph node metastasis, and lengthy protrusion of the peritoneum at the umbilical site are risk factors for IH after laparoscopic surgery for colorectal cancer. An assessment using these factors before the operation and the implementation of countermeasures might help prevent IH.

Citations

Citations to this article as recorded by

Incisional hernia after continuous barbed versus interrupted non-barbed sutures for midline fascial closure in minimally invasive colorectal cancer surgery: a propensity score-matched analysis
Kinuko Nagayoshi, Yusuke Mizuuchi, Takaaki Fujimoto, Koji Tamura, Kohei Nakata, Kenoki Ohuchida, Masafumi Nakamura
Hernia.2026;[Epub] CrossRef
Comparative analysis of longitudinal and transverse minilaparotomy during colon cancer surgery
Z.A. Bagatelija, D.N. Grekov, S.S. Lebedev, V.M. Kulushev, N.Ju. Sokolov, G.S. Mikhailyants, A.Yu. Lukin, A.A. Polikarpov, M.S. Lebedko, A.I. Maksimkin, A.S. Sharenkova
Pirogov Russian Journal of Surgery.2025; (4): 71. CrossRef
Effect of transverse versus midline periumbilical incision on incisional hernia and short-term outcomes after laparoscopic colon cancer surgery: multicentre, open-label, randomized clinical trial
Soo Young Lee, Soo Yeun Park, Gi Won Ha, Gyung Mo Son, Dong Keon Yon, Chang Hyun Kim, S Kim, S I Kang, J S Park, K H Lee, J S Kim, K B Bae, S U Bae
BJS Open.2025;[Epub] CrossRef
Umbilical fat is useful for evaluating the risk of incisional hernia after laparoscopic colorectal surgery
Chika Katayama, Yasuaki Enokida, Takuya Shiraishi, Yuta Shibasaki, Takuhisa Okada, Katsuya Osone, Akihiko Sano, Makoto Sakai, Hiroomi Ogawa, Ken Shirabe, Hiroshi Saeki
Surgery Today.2025;[Epub] CrossRef
Subcutaneous Fat, Not Visceral Fat, as a Risk Factor for Incisional Hernia After Laparoscopic Colorectal Cancer Surgery
Kumiko Sekiguchi, Akihisa Matsuda, Takeshi Yamada, Satoshi Matsumoto, Keisuke Minamimura, Youichi Kawano, Takeshi Matsutani, Hiroshi Maruyama, Nobuhiko Taniai, Yoshiharu Nakamura, Hiroshi Yoshida
Asian Journal of Endoscopic Surgery.2025;[Epub] CrossRef
Outcomes of elective and emergency surgical repair of incisional hernia: a comparative observational study
I. Omar, A. Townsend, O. Hadfield, T. Zaimis, M. Ismaiel, J. Wilson, C. Magee
Hernia.2024; 28(5): 1619. CrossRef
The first case of robotic‐assisted transabdominal retrorectus repair for incisional hernia in Japan
Gen Shimada, Taketo Matsubara, Mariko Sanbonmatsu, Rumi Nakabayashi, Yosuke Miyachi, Takashi Taketa, Akihiro Suzuki, Tadao Yokoi, Toshimi Kaido
Asian Journal of Endoscopic Surgery.2023; 16(2): 305. CrossRef
Mid-term outcomes of intracorporeal versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study from a single institution
Heita Ozawa, Naoyuki Toyota, Junichi Sakamoto, Hiroki Nakanishi, Ryo Nakanishi, Shin Fujita
Surgery Today.2023; 53(8): 992. CrossRef
Impact of non-muscle cutting periumbilical transverse incision on the risk of incisional hernia as compared to midline incision during laparoscopic colon cancer surgery: a study protocol for a multi-centre randomised controlled trial
Soo Yeun Park, Gi Won Ha, Soo Young Lee, Chang Hyun Kim, Gyung Mo Son
Trials.2023;[Epub] CrossRef

Case Reports

A rare presentation of low-grade appendiceal mucinous neoplasm within an amyand’s hernia: a case report: Hani Atiqah Saim, Ian Chik, Fahrol Fahmy Jaafar, Zamri Zuhdi, Razman Jarmin, Azlanudin Azman; Ann Coloproctol. 2023;39(2):183-187. Published online October 18, 2021; DOI: https://doi.org/10.3393/ac.2021.00430.0061

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5 Web of Science
3 Citations

Abstract PDF

An Amyand’s hernia is characterised as the presence of the appendix in an inguinal hernial sac. During laparoscopic cholecystectomy for gallbladder polyps, an incidental Amyand’s hernia was discovered in a 75-year-old female patient. On examination, the hernia contained an appendiceal mucocele but no evidence of perforation. An open appendicectomy with tension-free mesh repair was performed for the hernia. The histopathological report of the appendix was a low-grade appendiceal mucinous neoplasm (LAMN), an entity that is just as rare as an Amyand’s hernia. The patient had the right inguinal swelling for over 10 years but it was thought to be an inguinal intramuscular cyst as reported on a previous abdominal ultrasound. Mucocele of the appendix may have a benign or malignant appendiceal progress, leading to individualised diagnosis and treatment. We review an Amyand’s hernia with LAMN and discuss the asymptomatic tendency yet malignant potential of appendiceal mucoceles along with treatment strategies.

Citations

Citations to this article as recorded by

Molecular characterization of Pseudomyxoma peritonei with single-cell and bulk RNA sequencing
Ye Jin Ha, Seong-Hwan Park, Seon-Kyu Kim, Ka Hee Tak, Jeong-Hwan Kim, Chan Wook Kim, Yong Sik Yoon, Seon-Young Kim, Jong Lyul Lee
Scientific Data.2025;[Epub] CrossRef
Incidental appendiceal mucocele discovery: A case series and literature review
Nathaniel Grabill, Mena Louis, Jonathan W. Ray, Ana Tucker, Travelyan Walker, James Chambers
International Journal of Surgery Case Reports.2025;[Epub] CrossRef
Complicated Appendicitis Associated With Appendiceal Mucinous Neoplasm Within Amyand’s Hernia in a Patient With Previous Hernia Repair: A Case Report and Literature Review
Carlos A Navarro-Castañeda, Luis A Pérez-Silva, Rubén A Sandoval-Barba, Nubia A Ramírez-Buensuceso-Conde, Jorge Farell-Rivas
Cureus.2024;[Epub] CrossRef

Benign GI diease,Rare disease & stoma

De Garengeot’s Hernia Treated With a Hybrid Approach: A Case Report: Mohamed Alkashty, Ben Dickinson, Giovanni D. Tebala; Ann Coloproctol. 2021;37(Suppl 1):S55-S57. Published online May 28, 2021; DOI: https://doi.org/10.3393/ac.2020.09.21.2

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2 Web of Science
3 Citations

Abstract PDF

De Garengeot’s hernia happens when an inflamed or ischemic appendix is located within an incarcerated femoral hernia. We hereby report a case of De Garengeot’s hernia treated with a combined open and laparoscopic approach. An 80-year-old male presented to the emergency department with a 1-day history of a tender right inguinal mass. A computed tomography scan revealed a direct right inguinal hernia containing an incarcerated appendix. At surgery, the diagnosis of a strangulated appendix within a femoral hernia was made. To avoid a wide disruption of the right groin region, the ischemic appendix was reduced into the abdomen and removed laparoscopically. The femoral defect was treated by open plug repair. De Garengeot’s hernia may represent a surgical challenge. A combined open and laparoscopic approach is a good option in these cases.

Citations

Citations to this article as recorded by

Two Cases of De Garengeot Hernia: Combined Laparoscopic and Open Surgical Approach
Michelle M Dugan, MD
Journal of Pediatric Advance Research.2025; : 1. CrossRef
The Utility of Minimally Invasive Surgery in the Emergency Management of Femoral Hernias: A Systematic Review
Paul Shuttleworth, Shariq Sabri, Andrei Mihailescu
Journal of Abdominal Wall Surgery.2023;[Epub] CrossRef
Transverse colon and omental incarceration in femoral hernia: a case report
Badhaasaa Beyene Bayissa, Ayantu Mekonnon Borena
Journal of Surgical Case Reports.2023;[Epub] CrossRef

Benign GI diease,Complication

Transmural Mesh Migration From the Abdominal Wall to the Rectum After Hernia Repair Using a Prolene Mesh: A Case Report: Yujin Lee, Byung-Noe Bae; Ann Coloproctol. 2021;37(Suppl 1):S28-S33. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.19

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7 Web of Science
8 Citations

Abstract PDF

Mesh erosion or migration is a rare and late complication after hernia repair. Its incidence is increasing as the utilization of prosthetic mesh gains popularity for abdominal hernia repair. However, mesh migration is exceedingly rare and its clinical presentation is atypical and diverse. Therefore, the management of mesh migration should be individualized to each patient. This research reports the case of a 94-year-old man with transmural migration of Prolene mesh (Ethicon) from the abdominal wall to the rectum 14 years after incisional hernia repair. He presented with only chronic abdominal pain and constipation. Migration of the mesh and a fistula between the right abdominal wall and transverse colon was observed on computed tomography. The mesh was evacuated manually from the anus without any sequelae. These findings made this case atypical, since complete transluminal migration of mesh is exceedingly rare and mesh erosion or migration requires surgical treatment in many cases.

Citations

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Clinical Insights and Brief Research Report on Mesh Erosion Into Bowel Following Hernia Repair: A Single-Centre Series of Eight Cases
Vidit Dholakia, Suvendu Sekhar Jena, Amitabh Yadav, Samiran Nundy
Journal of Abdominal Wall Surgery.2025;[Epub] CrossRef
An unlikely path: hernia mesh migration
Ana Rita Ferreira, Bárbara Castro, Catarina Ortigosa, Sílvia Costa, Bela Pereira, Manuel Oliveira
European Surgery.2024; 56(1-2): 39. CrossRef
Spontaneous Migration of Intraperitoneal Mesh into Rectum following Ventral Hernia Repair
Aruna R. Patil, Ravishankar Bhat, Madhusudhana Basavarajappa
Journal of Gastrointestinal and Abdominal Radiology.2023; 06(01): 053. CrossRef
Gastrocutaneous fistula caused by mesh migration following diaphragmatic rupture repair
Yuan Zhang, Jun Peng, Xingui Wu, Dingjiao Zhu, Yaozhi Chen
ANZ Journal of Surgery.2023; 93(4): 1042. CrossRef
Enterocutaneous fistula from a mesh eroding the small bowel after incisional hernia repair
Michael L. Lorentziadis, Moustafa Mahmoud Nafady Hego, Fatma Al Nasser
International Journal of Abdominal Wall and Hernia Surgery.2023; 6(1): 48. CrossRef
Does intraperitoneal mesh increase the risk of bowel obstruction? A nationwide French analysis
Théophile Delorme, Jonathan Cottenet, Fawaz Abo-Alhassan, Alain Bernard, Pablo Ortega-Deballon, Catherine Quantin
Hernia.2023; 28(2): 419. CrossRef
A Cecal Surprise
Muhammad B. Hammami, Jean-Pierre Raufman
Gastroenterology.2022; 162(7): 1847. CrossRef
Mesh on the move: a case report of total transmural surgical mesh migration causing bowel obstruction
Joseph Ryan Leach, Bryan Manoukian, Lygia Stewart
Clinical Journal of Gastroenterology.2021; 14(1): 136. CrossRef

Spontaneous Transomental Hernia: Seung Hun Lee, Seung Hyun Lee; Ann Coloproctol. 2016;32(1):38-41. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.38

7,060 View
47 Download
15 Web of Science
17 Citations

Abstract PDF

A transomental hernia through the greater or lesser omentum is rare, accounting for approximately 4% of internal hernias. Transomental hernias are generally reported in patients aged over fifty. In such instances, acquired transomental hernias are usual, are commonly iatrogenic, and result from surgical interventions or from trauma or peritoneal inflammation. In rare cases, such as the one described in this study, internal hernias through the greater or lesser omentum occur spontaneously as the result of senile atrophy without history of surgery, trauma, or inflammation. A transomental hernia has a high postoperative mortality rate of 30%, and emergency diagnosis and treatment are critical. We report a case of a spontaneous transomental hernia of the small intestine causing intestinal obstruction. An internal hernia with strangulation of the small bowel in the lesser sac was suspected from the image study. After an emergency laparotomy, a transomental hernia was diagnosed.

Citations

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Spontaneous omental hernia posing a diagnostic challenge in a patient with multiple hernias: a case report
Blessing Ngoin Ngam, Faith Bih Irene Keba, Chinonso Paul Shu, Guillaume Nzepah Foletia, Elvis Sonfack
International Journal of Surgery Open.2026; 64(1): 27. CrossRef
Spontaneous transomental hernia: a rare cause of closed loop bowel obstruction
Caitlin Zhang, Marie Shella De Robles
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Real‐time ancillary diagnostics for intraoperative assessment of intestinal viability in horses–looking for answers across species
Nicole Verhaar, Florian Geburek
Veterinary Surgery.2025; 54(4): 648. CrossRef
CT imaging of a rare combined internal hernia traversing the lesser sac via the gastrocolic ligament and foramen of Winslow
Quanxu Ge, Peixia Cong
Egyptian Journal of Radiology and Nuclear Medicine.2025;[Epub] CrossRef
Congenital transmesocolic internal hernia as a cause of sudden death – autopsy case report
Veljko Milošević, Milenko Bogdanović, Milena Kontić-Žarčanin, Tijana Petrović, Bojana Radnić
Legal Medicine.2025; 79: 102732. CrossRef
Small bowel obstruction due to spontaneous transomental hernia in an octogenarian patient: a case report
Oğuzhan Şimşek, Muhammer Ergenç
Journal of Trends in Medical Investigation.2025; 1(3): 97. CrossRef
Spontaneous transomental hernia: a case report of a rare internal hernia with a challenging diagnosis
Mohamed Ben Khalifa, Mossaab Ghannouchi, Achref Sarraj, Sabri Aouadi, Mohamed Maatouk, Moez Boudokhane
Annals of Medicine & Surgery.2024; 86(11): 6865. CrossRef
Case Report: A small bowel occlusion revealed by a strangulated transomental hernia
AHMED MENIF, SOUHAIB ATRI, WASSIM RIAHI, HELMI ZEBDA
F1000Research.2024; 13: 1394. CrossRef
Internal Hernia: An Uncommon and Often-Missed Differential Diagnosis of Abdominal Pain
Chaitanya Mishra, Khawaja O Omar
Cureus.2024;[Epub] CrossRef
Transomental Hernia: Rare Presentation in a Virgin Abdomen
Asiyah Shafi, Fatema Karmustaji, Muhammad Umar Younis, Monis Ahmed, Roger Gergy
Cureus.2024;[Epub] CrossRef
Lesser omental hernia through a defect in the posterior layer of the lesser omentum
Hirotaka Shibuya, Keita Sato, Yosuke Yamauchi, Yoshihisa Tamura, Koji Takahashi, Yasushi Asari
Surgical Case Reports.2023;[Epub] CrossRef
Spontaneous lesser omental herniation resolved by laparoscopic surgery: case report and systematic literature review
André S. Alves, Alexandre Balaphas, Katie Zuo, Philipp Hauser, Angeliki Neroladaki, Toni Raffoul
Surgical Endoscopy.2023; 37(9): 6704. CrossRef
Strangulated transomental hernia in virgin abdomen: laparoscopic surgery with a small laparotomy may be useful to assess the indeterminate viability of the bowel
Toyoaki Sawano, Tomohiro Kurokawa, Akihiko Ozaki, Divya Bhandari, Mioko Furuya, Yoshiaki Kanemoto, Masaharu Tsubokura, Tomozo Ejiri, Norio Kanzaki
Journal of Surgical Case Reports.2022;[Epub] CrossRef
Small Bowel Obstruction Caused by Spontaneous Transomental Hernia: A Case Report
So Ra Ahn, Keun Young Kim, Joo Hyun Lee
The Korean Journal of Gastroenterology.2022; 80(4): 186. CrossRef
Transomental hernia – An enigmatic case report causing bowel obstruction in a virgin abdomen
Latifa Al Buainain, Kiran B. Kaundinya, Faizal N. Hammed
International Journal of Surgery Case Reports.2020; 66: 88. CrossRef
Laparoscopic surgery for two patients with strangulated transomental hernias
Yuka Fujimoto, Yuki Ohya, Shintaro Hayashida, Masayoshi Iizaka, Yuto Maeda, Sayahito Kumamoto, Akira Tsuji, Hidekatsu Shibata, Kunitaka Kuramoto, Hironori Hayashi, Osamu Nakahara, Shinjiro Tomiyasu, Yukihiro Inomata
Surgical Case Reports.2020;[Epub] CrossRef
Displacement of the transverse colon is a highly specific computed tomography finding for the preoperative diagnosis of a transomental hernia
Ryota Ito, Kazuhiko Mori, Keisuke Minamimura, Toru Hirata, Takashi Kobayashi, Seiji Kawasaki
Japanese Journal of Radiology.2019; 37(8): 605. CrossRef

Mesh-Based Transperineal Repair of a Perineal Hernia After a Laparoscopic Abdominoperineal Resection: Taek-Gu Lee, Sang-Jeon Lee; Ann Coloproctol. 2014;30(4):197-200. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.197

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12 Web of Science
11 Citations

Abstract PDF

A perineal hernia (PH) is formed by a protrusion of intra-abdominal viscera through a defect in the pelvic floor. This is a rare complication after a conventional abdominoperineal resection (APR). However, the risk of a PH may be increased after a laparoscopic resection because this technique can cause fewer postoperative adhesions, predisposing the small bowel to sliding down toward the pelvis. However, only a few case reports describe the transperineal approach for the repair of a PH after a laparoscopic APR. We present a case of a PH after a laparoscopic APR; the PH was repaired with synthetic mesh by using a transperineal approach. A transperineal approach using a mesh to reconstruct the pelvic floor is less invasive and more effective. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.

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Perineal Hernias: Diagnosis and surgical management
Ahad Azimuddin, Saieesh A. Rao, Mohammad Ali Abbass
Seminars in Colon and Rectal Surgery.2026; 37(1): 101162. CrossRef
Perineal hernia repair with synthetic mesh and bivectorial gluteus maximus myocutaneous island flap
Inês Carreira, Nelson Teixeira, Alexandra Rosa, José Guerreiro, Joana Pedro Marques
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Perineal hernia after abdominoperineal resection – a systematic review
Sajad Ahmad Salati, Amr Y. Arkoubi
Polish Journal of Surgery.2022; 94(6): 61. CrossRef
The impact of laparoscopic technique on the rate of perineal hernia after abdominoperineal resection of the rectum
Anna J. Black, Ahmer Karimuddin, Manoj Raval, Terry Phang, Carl J. Brown
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The Application of Extraperitoneal Ostomy Combined with Pelvic Peritoneal Reconstruction in Laparoscopic Abdominoperineal Resection for Rectal Cancer
Sen Wang, Qingyang Meng, Jun Gao, Yuqin Huang, Jie Wang, Yang Chong, Youquan Shi, Huaicheng Zhou, Wei Wang, Dong Tang, Daorong Wang
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Perineal hernia mesh repair: a fixation with glue, sutures and tacks. How to do it
L. Hassan, A. Beunis, M. Ruppert, V. Dhooghe, S. Van den Broeck, G. Hubens, N. Komen
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Transvaginal Small Bowel Evisceration following Abdominoperineal Resection
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Case Reports in Surgery.2018; 2018: 1. CrossRef
Composite mesh and gluteal fasciocutaneous rotation flap for perineal hernia repair after abdominoperineal resection: a novel technique
Marios Papadakis, Gunnar Hübner, Marzena Bednarek, Mohamed Arafkas
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Perineal hernia repair after abdominoperineal excision or extralevator abdominoperineal excision: a systematic review of the literature
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Short-term Outcomes of an Extralevator Abdominoperineal Resection in the Prone Position Compared With a Conventional Abdominoperineal Resection for Advanced Low Rectal Cancer: The Early Experience at a Single Institution
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Original Articles

Analysis of Risk Factors for the Development of Incisional and Parastomal Hernias in Patients after Colorectal Surgery: In Ho Song, Heon-Kyun Ha, Sang-Gi Choi, Byeong Geon Jeon, Min Jung Kim, Kyu Joo Park; J Korean Soc Coloproctol. 2012;28(6):299-303. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.299

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33 Citations

Abstract PDF

Purpose

The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery.

Methods

The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed.

Results

The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias.

Conclusion

Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.

Citations

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Abdominal Incisions and Hernia Development: A Systematic Review and Meta-Analysis of Risk Factors
Fahim Kanani, Nir Messer, Alaa Zahalka, Moshe Kamar, Narmin Zoabi
The American Surgeon™.2026; 92(2): 590. CrossRef
Risk factors of incisional hernia enlargement after colorectal cancer surgery: a retrospective, single-center study
Koki Tamai, Mitsuyoshi Tei, Naoto Tsujimura, Kentaro Nishida, Soichiro Mori, Yukihiro Yoshikawa, Masatoshi Nomura, Nobuyoshi Ohara, Takuya Hamakawa, Daisuke Takiuchi, Masanori Tsujie, Yusuke Akamaru
Surgery Today.2026; 56(3): 267. CrossRef
Propensity Score Analysis of the Utility of Supervised Perioperative Abdominal Wall Exercises for the Prevention of Parastomal Hernia
Victoria Alejandra López-Callejón, Amparo Yuste-Sanchez, Mayed Murad, Rut Navarro-Martínez, Leticia Pérez-Santiago, José Martín-Arevalo, David Moro-Valdezate, Vicente Pla-Martí, David Casado-Rodriguez, Alejandro Espí-Macías, Stephanie García-Botello
Nursing Reports.2025; 15(2): 62. CrossRef
Comparing the effectiveness of prophylactic strategies for parastomal hernia prevention: a network meta-analysis
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Incidence and Risk Factors of Parastomal Hernia: Yeun Ju Sohn, Sun Mi Moon, Ui Sup Shin, Sun Hee Jee; J Korean Soc Coloproctol. 2012;28(5):241-246. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.241

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Abstract PDF

Purpose

Among the various stoma complications, the parastomal hernia (PSH) is the most common. Prevention of PSH is very important to improve the quality of life and to prevent further serious complications. The aim of this study was to analyze the incidence and the risk factors of PSH.

Methods

From January 2002 and October 2008, we retrospectively reviewed 165 patients who underwent an end colostomy. As a routine oncologic follow-up, abdomino-pelvic computed tomography was used to examine the occurrence of the PSH. The associations of age, sex, body mass index (BMI), history of steroid use and comorbidities to the development of the PSH were analyzed. The median duration of the follow-up was 36 months (0 to 99 months).

Results

During follow-up, 50 patients developed a PSH and the 5-year cumulative incidence rate of a PSH, obtained by using the Kaplan-Meier method, was 37.8%. In the multivariate COX analysis, female gender (hazard ratio [HR], 3.29; 95% confidence interval [CI], 1.77 to 6.11; P < 0.0001), age over 60 years (HR, 2.37; 95% CI, 1.26 to 4.46; P = 0.01), BMI more than 25 kg/m² (HR, 1.8; 95% CI, 1.02 to 3.16; P = 0.04), and hypertension (HR, 2.08; 95% CI, 1.14 to 3.81; P = 0.02) were all independent risk factors for the development of a PSH.

Conclusion

The 5-year incidence rate of a PSH was 37.8%. The significant risk factors of a PSH were as follows: female gender, age over 60 years, BMI more than 25 kg/m², and hypertension. Using a prophylactic mesh during colostomy formation might be advisable when the patients have these factors.

Citations

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Surgical Treatment of a Parastomal Hernia: Seung Chul Heo, Heung-Kwon Oh, Yoon Suk Song, Mi Sun Seo, Eun Kyung Choe, Seungbum Ryoo, Kyu Joo Park; J Korean Soc Coloproctol. 2011;27(4):174-179. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.174

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Abstract PDF

Purpose

Parastomal hernia is a major complication of an intestinal stoma. This study was performed to compare the results of various operative methods to treat parastomal hernias.

Methods

Results of surgical treatment for parastomal hernias (postoperative recurrence, complications and postoperative hospital stays) were surveyed in 39 patients over an 11-year period. The patients enrolled in this study underwent surgery by a single surgeon to exclude surgeon bias.

Results

Seventeen patients were male, and twenty-two patients were female. The mean age was 65.9 years (range, 36 to 86 years). The stomas were 35 sigmoid-end-colostomies (90%), 2 loop-colostomies (5%), and 2 double-barrel-colostomies. Over half of the hernias developed within two years after initial formation. Stoma relocation was performed in 8 patients, suture repair in 14 patients and mesh repair in 17 patients. Seven patients had recurrence of the hernia, and ten patients suffered from complications. Postoperative complications and recurrence were more frequent in stoma relocation than in suture repair and mesh repair. Emergency operations were performed in four patients (10.3%) with higher incidence of complications but not with increased risk of recurrence. Excluding emergency operations, complications of relocations were not higher than those of mesh repairs. Postoperative hospital stays were shortest in mesh repair patients.

Conclusion

In this study, mesh repair showed low recurrence and a low complication rate with shorter hospital stay than relocation methods, though these differences were not statistically significant. Further studies, including randomized trials, are necessary if more reliable data on the surgical treatment of parastomal hernias are to be obtained.

Citations

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Case Reports

A Case of Small Bowel Obstruction Due to a Paracecal Hernia: Eun-Jung Jang, Seung Hyun Cho, Dae-Dong Kim; J Korean Soc Coloproctol. 2011;27(1):41-43. Published online February 28, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.1.41

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Abstract PDF

Internal hernias are rare causes of small bowel obstruction, and one such internal hernia is the paracecal hernia. We report a case of a small bowel obstruction related to a paracecal hernia in which a preoperative diagnosis was made on computed tomography. A laparotomy was performed for definitive diagnosis and treatment. The surgery achieved a good outcome.

Citations

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Dmitriy M. Krasilnikov, Yaroslav Y. Nikolayev, Rushan Sh. Agliullin
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Surgical Management of Pericaecal Hernia in a Virgin Abdomen
Jia Ling Ong, Wei Chuan Tan, Kien Fatt Sean Lee, Kuan Yuen Yeong, Choon Sheong Seow
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Primary Repair of a Huge Incisional Hernia by Using an External Oblique Myofascial Releasing Technique without Mesh: A Case Report.: Park, Ki Jae , Woo, Jin Hee , Lee, Hak Youn , Lee, Se Yong , Shin, Jong Sok , Roh, Young Hoon , Kim, Sung Heun , Choi, Hong Jo; J Korean Soc Coloproctol. 2008;24(5):386-389.; DOI: https://doi.org/10.3393/jksc.2008.24.5.386

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Abstract PDF: Incisional hernias are one of the most common complications after abdominal surgery and are an important cause of postoperative morbidity. Various methods are available for repairing incisional hernias, such as primary suture repair, an open mesh technique, and a laparoscopic mesh technique. The surgical management of a large incisional hernia by using a prosthetic mesh in a contaminated operative field (i.e., opened bowel from previous stoma or bowel resection) remains a difficult challenge because the non-absorbable mesh used is accompanied by a potential risk of infection and its related morbidity. We present a case of a large abdominal-wall defect, which was corrected by utilizing an external oblique myofascial releasing technique without the use of mesh, in a patient with an incisional hernia coexistent with Hartmann's colostomy.

Colonic Obstruction Caused by Sigmoid Volvulus Combined with a Transomental Hernia: A Case Report.: Choi, Pyong Wha , Heo, Tae Gil , Park, Je Hoon , Lee, Myung Soo , Kim, Chul Nam , Chang, Surk Hyo , Kim, Nam Hoon , Bae, Won Ki , Moon, Young Soo; J Korean Soc Coloproctol. 2008;24(3):214-218.; DOI: https://doi.org/10.3393/jksc.2008.24.3.214

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Abstract PDF: The case of sigmoid volvulus combined with a transomental hernia is reported. A 70-year-old man was admitted to our hospital with mild abdominal pain and distension. Although no signs of peritoneal irritation were apparent, a plain abdominal X-ray showed a markedly dilated loop of the sigmoid colon, and CT revealed a whirl pattern of the sigmoid mesentery. These findings suggested sigmoid volvulus. Colonoscopic reduction was attempted as an initial nonoperative treatment, and an urgent laparotomy was performed after the reduction failed. The sigmoid loop was herniated through the great omentum, with torsion in the clockwise direction. The colon was manually untwisted in the counter-clockwise direction, and the sigmoid loop was released by dividing the great omentum. During this one-stage operation, intraoperative colonic irrigation, sigmoid resection, and primary anastomosis were performed. The postoperative course was uneventful. Although sigmoid volvulus combined with a transomental hernia is rare, urgent surgical intervention is essential on failure of endoscopic reduction.

A Case Report of Rectal Herniation through Rectovaginal Fistula Associated with Uterine Prolapse.: Lee, Sang Jeon; J Korean Soc Coloproctol. 2003;19(1):45-47.

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Abstract PDF: A rectovaginal fistula, associated with a uterine prolapse, is a very rare entity. The case presented here is that of an elderly woman with a uterine prolapse, associated with an anterior rectal wall herniation through a rectovaginal fistula just above the anorectal ring. It was thought the uterine prolapse had caused the weakness, and long diastasis, of the posterior vaginal wall and the rectovaginal fistula, and then the anterior rectal wall became herniated, with eversion through the rectovaginal fistula. A total abdominal hysterectomy, with bilateral salpingo-oophorectomy, was performed. The rectum was mobilized just beyond the level of the rectovaginal fistula, and resected at that point. Then, from a perineal approach, a coloanal anastomosis was performed using the Parks' sleeve anastomosis technique. After the repair of the long diastasis of the posterior vaginal wall, with inclusion of the fistula opening, a portion of the omentum was interposed between the posterior vaginal wall and the coloanal anastomosis site.

Internal Hernia in Adult Patients: Transmesenteric Hernia and Internal Hernia through a Defect of the Broad Ligament.: Lee, Sang Myong , Lee, In Kyu , Lee, Yoon Suk , Kang, Won Kyung , Ahn, Chang Hyeok , Lee, Do Sang , Jung, Seung Eun , Chang, Suk Kyun; J Korean Soc Coloproctol. 2006;22(6):428-431.

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Abstract PDF: An internal hernia is a rare disease that causes bowel obstruction. It is difficult to diagnose because the symptoms and the signs are the same as those for other obstructive diseases of the bowel. Early diagnosis and management are essential, and early surgical management may reduce complications such as ischemia, and strangulation. We experienced two cases of internal hernias. One patient underwent a laparotomy, and had a transmesenteric defect with a herniated and strangulated small bowel segment. The other patient underwent a laparoscopic surgery, and we found that the left broad ligament had a focal defect with a herniated small bowel segment. An internal hernia is an uncommon disease, and its differentiation from other obstructive diseases of the bowel is difficult. However, the clinician should consider that the internal hernia might be the cause of the bowel obstruction, especially in patient with no previous history of intra- abdominal surgery. Early diagnosis can improve the clinical outcome through early surgery.

Giant Transverse Colon Diverticulitis Presenting as Indirect Right Inguinal Hernia Strangulation.: Park, Weon Cheol , Lee, Jeong Kyun , Yoon, Seong Eon , Yun, Ki Jung; J Korean Soc Coloproctol. 2006;22(3):200-203.

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Abstract PDF: A giant colonic diverticulum is a rare complication of diverticulosis, and an inguinal hernia is a common diagnosis for patients presenting with a painful groin mass. A 52-year-old male presented to the emergency room with a 3-hour complaint of progressive, constant, right-groin pain with an inguinal mass. After manual reduction of the inguinal hernia, the patient complained of pain in the right upper quadrant. Operative findings showed a transverse colon diverticulitis without perforation. We report here that case of a transverse colon giant diverticulum presenting as an atypical incarcerated inguinal hernia.

Original Article

Clinical Characteristics of Inguinal Hernia Following Rectal Cancer Surgery.: Lee, Chang Min , Kim, Hee Cheol , Cho, Young Kyu , Hong, Hyun Kee , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2001;17(6):342-345.

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Abstract PDF: PURPOSE
The anatomic and physiologic changes after rectal cancer surgery was suggested to be a cause of inguinal hernia. But, there are only few reported cases about the inguinal hernia following rectal cancer surgery. The aim of this study is to verify risk factors and surgical techniques to prevent inguinal hernia following rectal cancer surgery.
METHODS
Out of 1226 patients who underwent operations at the Department of Surgery, Asan Medical Center, between the period from June 1989 to July 1999, 12 patients who had developed inguinal hernia and their medical records were reviewed retrospectively regarding the clinical characteristics.
RESULTS
The median duration of hernia following rectal cancer surgery was 12 (3-36) months. The median age was 63 (36-74) years with eight of them more than seventh decades of their life. All patients had male sex. Three of them were overweighted. Five cases had hernias on the left side, six on the right, and one case on both side. All patients had indirect inguinal hernia. Three cases had preoperative symptoms of bowel obstruction. The operations for rectal cancer were low anterior resection in eight cases, ultralow anterior resection in three cases, and abdominoperineal resection in one case. The complications in rectal cancer surgery were found in six cases. Six cases had the advanced stage. A postoperative radiation therapy was applied in five cases. Five cases had the coexisting diseases.
CONCLUSIONS
Male sex and old age would be related with occuring inguinal hernia after rectal cancer surgery and, it would be necessary to give a special attention to the patients who have these factors, although the present study could not show the definite correlation between inguinal hernia and rectal cancer surgery due to a small number of cases.

Case Report

Laparoscopic Giant Parastomal Hernia Repair.: Lee, Yoon Suk , Lee, In Kyu , Oh, Seung Teak , Kim, Jun Gi , Jang, Suk Kyun , Kim, Young Ha; J Korean Soc Coloproctol. 2005;21(5):325-328.

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Abstract PDF: Parastomal hernia is not an uncommon complication after stoma formation. Although there are a variety of open surgical techniques, rates of morbidity, recurrence and complications are high. Nowadays, with improvements in techniques and equipment, laparoscopic surgery is being increasingly used in every field of surgery. Herein, we present a case study of a patient suffering from a large parastomal hernia who underwent a laparoscopic hernia repair. A 71-year-old man who had undergone an abdominoperineal resection for an adenocarcinoma of the rectum 5 years ago was admitted to our hospital for a large parastomal hernia, which was repaired by using a laparoscopic approach with Gore-Tex and protack (auto-suture(R), USA). We found the laparoscopic approach for a large parastomal hernia to be technically feasible and to be a good alternative to conventional open surgery with the advantage of minimal invasivess.

Original Article

A Parastomal Hernia Causing Small Bowel Obstruction.: Lee, Seung Hoon , Jeon, Hae Myung , Kim, Jeong Soo , Kim, Kee Hwan , Oh, Seong Taek , Chae, Hun Suk; J Korean Soc Coloproctol. 1999;15(4):345-349.

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Abstract PDF: A parastomal hernia is an incisional hernia in relation to an intestinal stoma on the abdominal wall and a common complication after stoma formation. Most parastomal hernias are relatively asymptomatic, but sometimes, a loop of bowel may become trapped in the sac, resulting in obstruction or strangulation. We reported a case with a para-colostomy hernia causing small bowel obstruction in a 45-years-old female who had had a transverse loop colostomy for severe rectovaginal fistula 2 years before due to recurrent cervix cancer. The patient required resection of gangrenous portions of small bowel and large bowel. A review of the preventative information of parastomal hernia and management is discussed. A parastomal hernia shonld be considered as a cause of small bowel obstruction in anyone who has a stoma. Early detection and repair of the strangulated hernia are recommended.

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