Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2022; 10(8): 2637-2643
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2637
Drain-site hernia after laparoscopic rectal resection: A case report and review of literature
Jin Su, Cheng Deng, Hui-Ming Yin
Jin Su, Department of General Surgery, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital of Xiangya Medical College of Central South University, Zhuzhou 412000, Hunan Province, China
Cheng Deng, Division of Science and Education, Zhuzhou Central Hospital, The Affiliated Zhuzhou Hospital of Xiangya Medical College of Central South University, Zhuzhou 412000, Hunan Province, China
Hui-Ming Yin, Department of General Surgery, the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410000, Hunan Province, China
Author contributions: Deng C acquired and interpreted the clinical data; Su J reviewed the literature and drafted the manuscript; Yin HM made substantial contributions to the conception and design of the work; all authors read and approved the final manuscript.
Supported by the Project of Health Commission of Hunan Province of China, NO. 20201853.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin Su, MD, Attending Doctor, Department of General Surgery, Zhuzhou Central Hospital, the Affiliated Zhuzhou Hospital of Xiangya Medical College of Central South University, No. 116 Changjiang South Road, Zhuzhou 412000, Hunan Province, China. sujin2012@126.com
Received: October 18, 2021
Peer-review started: October 18, 2021
First decision: December 17, 2021
Revised: December 27, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: March 16, 2022
Processing time: 143 Days and 15.3 Hours
Abstract
BACKGROUND

Drain-site hernia (DSH) has an extremely low morbidity and has rarely been reported. Small bowel obstruction is a frequent concurrent condition in most cases of DSH, which commonly occurs at the ≥ 10 mm drain-site. Here we report a rare case of DSH at the lateral 5 mm port site one month postoperatively without visceral incarceration. Simultaneously, a brief review of the literature was conducted focusing on the risk factors, diagnosis, and prevention strategies for DSH.

CASE SUMMARY

A 76-year-old male patient was admitted to our institution with intermittent abdominal pain and a local abdominal mass which occurred one month after laparoscopic radical resection of rectal cancer one year ago. A computed tomography scan showed an abdominal wall hernia at the 5 mm former drain-site in the left lower quadrant, and that the content consisted of the large omentum. An elective herniorrhaphy was performed by closing the fascial defect and reinforcing the abdominal wall with a synthetic mesh simultaneously. The postoperative period was uneventful. The patient was discharged seven days after the operation without surgery-related complications at the 1-mo follow-up visit.

CONCLUSION

Emphasis should be placed on DSH despite the decreased use of intra-abdominal drainage. It is recommended that placement of a surgical drainage tube at the ≥ 10 mm trocar site should be avoided. Moreover, it is advisable to have a comprehensive understanding of the risk factors for DSH and complete closure of the fascial defect at the drainage site for high-risk patients.

Keywords: Drain-site hernia; Abdominal hernia; Laparoscopic surgery; Surgical drainage; Risk factor; Case report

Core Tip: Drain-site hernia (DSH) is rarely reported at the 5 mm trocar site. In most cases, we prefer to place a large drainage tube at the ≥ 10 mm trocar site and directly remove it postoperatively without any measures to manage the fascial defects, and fail to continuously monitor co-existing disorders which may accelerate DSH formation. These situations may result in the development of DSH in some cases. Here, we report a rare case associated with a literature review to briefly summarize the risk factors, diagnosis, and prevention strategies for DSH.