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Research article
Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era
Yuji Nishizawa
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7263-2424
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
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.
Keywords
laparoscopic surgery, parastomal hernia, peristomal skin disorders, risk factors, stoma-related complications
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CURRENT STATUS: Published
Version 4
Posted 01 Jun, 2020
Published
On 22 Jun, 2020
No community comments so far
Editorial decision: Minor revision
On 12 Jun, 2020
Review #1 received
Received 29 May, 2020
Reviewer #1 agreed
On 26 May, 2020
Reviewers invited
Invitations sent on 25 May, 2020
Editor assigned
On 25 May, 2020
Submission checks complete
On 24 May, 2020
Editor invited
On 24 May, 2020
No comments provided
Editorial decision: Minor revision
On 19 May, 2020
Reviewers invited
Invitations sent on 12 May, 2020
Reviewer #1 agreed
On 12 May, 2020
Reviewer #2 agreed
On 12 May, 2020
Review #1 received
Received 12 May, 2020
Review #2 received
Received 12 May, 2020
Editor assigned
On 05 May, 2020
Editor invited
On 04 May, 2020
Submission checks complete
On 30 Jul, 2019
No comments provided
Editorial decision: Major revision
On 29 Apr, 2020
Review #2 received
Received 28 Apr, 2020
Review #1 received
Received 20 Apr, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Editor assigned
On 15 Apr, 2020
Reviewers invited
Invitations sent on 15 Apr, 2020
Reviewer #1 agreed
On 15 Apr, 2020
Submission checks complete
On 14 Apr, 2020
Editor invited
On 14 Apr, 2020
No comments provided
Editorial decision: Major revision
On 06 Feb, 2020
Review #3 received
Received 30 Jan, 2020
Reviewer #3 agreed
On 14 Jan, 2020
Review #1 received
Received 23 Nov, 2019
Review #2 received
Received 23 Nov, 2019
Reviewer #2 agreed
On 15 Nov, 2019
Reviewer #1 agreed
On 29 Oct, 2019
Reviewers invited
Invitations sent on 01 Oct, 2019
Editor assigned
On 04 Aug, 2019
Submission checks complete
On 03 Aug, 2019
Editor invited
On 01 Aug, 2019
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Subject Areas
General Surgery
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This preprint is under consideration at BMC Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era
Yuji Nishizawa
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7263-2424
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 01 Jun, 2020
Published
On 22 Jun, 2020
No community comments so far
Editorial decision: Minor revision
On 12 Jun, 2020
Review #1 received
Received 29 May, 2020
Reviewer #1 agreed
On 26 May, 2020
Reviewers invited
Invitations sent on 25 May, 2020
Editor assigned
On 25 May, 2020
Submission checks complete
On 24 May, 2020
Editor invited
On 24 May, 2020
No comments provided
Editorial decision: Minor revision
On 19 May, 2020
Reviewers invited
Invitations sent on 12 May, 2020
Reviewer #1 agreed
On 12 May, 2020
Reviewer #2 agreed
On 12 May, 2020
Review #1 received
Received 12 May, 2020
Review #2 received
Received 12 May, 2020
Editor assigned
On 05 May, 2020
Editor invited
On 04 May, 2020
Submission checks complete
On 30 Jul, 2019
No comments provided
Editorial decision: Major revision
On 29 Apr, 2020
Review #2 received
Received 28 Apr, 2020
Review #1 received
Received 20 Apr, 2020
Reviewer #2 agreed
On 16 Apr, 2020
Editor assigned
On 15 Apr, 2020
Reviewers invited
Invitations sent on 15 Apr, 2020
Reviewer #1 agreed
On 15 Apr, 2020
Submission checks complete
On 14 Apr, 2020
Editor invited
On 14 Apr, 2020
No comments provided
Editorial decision: Major revision
On 06 Feb, 2020
Review #3 received
Received 30 Jan, 2020
Reviewer #3 agreed
On 14 Jan, 2020
Review #1 received
Received 23 Nov, 2019
Review #2 received
Received 23 Nov, 2019
Reviewer #2 agreed
On 15 Nov, 2019
Reviewer #1 agreed
On 29 Oct, 2019
Reviewers invited
Invitations sent on 01 Oct, 2019
Editor assigned
On 04 Aug, 2019
Submission checks complete
On 03 Aug, 2019
Editor invited
On 01 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
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