Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era
Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed.
Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients who underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at our hospital from January to December 2016.
Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the rectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p=0.005) during the median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing through the middle of the rectus abdominis muscle, the only independent factor associated with this misplacement of the stoma was a laparoscopic approach (p=0.012). An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia (p=0.049).
Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk factor. Moreover, parastomal hernia is significantly associated with peristomal skin disorders.
Figure 1
Posted 01 Jun, 2020
On 22 Jun, 2020
On 12 Jun, 2020
Received 29 May, 2020
On 26 May, 2020
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Received 12 May, 2020
Received 12 May, 2020
On 05 May, 2020
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On 30 Jul, 2019
On 29 Apr, 2020
Received 28 Apr, 2020
Received 20 Apr, 2020
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On 15 Apr, 2020
On 14 Apr, 2020
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Received 30 Jan, 2020
On 14 Jan, 2020
Received 23 Nov, 2019
Received 23 Nov, 2019
On 15 Nov, 2019
On 29 Oct, 2019
Invitations sent on 01 Oct, 2019
On 04 Aug, 2019
On 03 Aug, 2019
On 01 Aug, 2019
Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era
Posted 01 Jun, 2020
On 22 Jun, 2020
On 12 Jun, 2020
Received 29 May, 2020
On 26 May, 2020
Invitations sent on 25 May, 2020
On 25 May, 2020
On 24 May, 2020
On 24 May, 2020
On 19 May, 2020
Invitations sent on 12 May, 2020
On 12 May, 2020
On 12 May, 2020
Received 12 May, 2020
Received 12 May, 2020
On 05 May, 2020
On 04 May, 2020
On 30 Jul, 2019
On 29 Apr, 2020
Received 28 Apr, 2020
Received 20 Apr, 2020
On 16 Apr, 2020
On 15 Apr, 2020
Invitations sent on 15 Apr, 2020
On 15 Apr, 2020
On 14 Apr, 2020
On 14 Apr, 2020
On 06 Feb, 2020
Received 30 Jan, 2020
On 14 Jan, 2020
Received 23 Nov, 2019
Received 23 Nov, 2019
On 15 Nov, 2019
On 29 Oct, 2019
Invitations sent on 01 Oct, 2019
On 04 Aug, 2019
On 03 Aug, 2019
On 01 Aug, 2019
Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed.
Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients who underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at our hospital from January to December 2016.
Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the rectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p=0.005) during the median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing through the middle of the rectus abdominis muscle, the only independent factor associated with this misplacement of the stoma was a laparoscopic approach (p=0.012). An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia (p=0.049).
Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk factor. Moreover, parastomal hernia is significantly associated with peristomal skin disorders.
Figure 1