Clinical and Radiologic Predictors of Parastomal Hernia Development After End Colostomy

Pennings, Jan Pieter; Kwee, Thomas C.; Hofman, S.; Viddeleer, Alain R.; Furnée, Edgar J.B.; Ooijen, Peter M. A. van; Haas, Robbert J. de

doi:10.2214/ajr.19.22498

Cited by 21 publications

(10 citation statements)

References 17 publications

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“…We also found that PSH was significantly increased in patients with diabetes mellitus (HR 1.81) and COPD (HR 1.78). Although colorectal studies have disclosed this association [16,17], to our knowledge, this is the first study in the field of urology that validates the predisposing role of these two factors. Diabetes and COPD may increase the risk of PSH through collagen synthesis impairment and chronic increase in intra‐abdominal pressure, respectively.…”

Section: Discussionmentioning

confidence: 76%

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

et al. 2021

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Objective To investigate the incidence, risk factors and natural history of parastomal hernia (PSH). Materials and Methods We reviewed the records of patients who underwent radical cystectomy (RC) and ileal conduit (IC) procedure between 2007 and 2020. Patients who had available follow‐up computed tomography (CT) imaging were included in this study. All CT scans were re‐reviewed for detection of PSH according to Moreno‐Matias classification. Patients who developed hernia were followed up and classified into stable or progressive (defined as radiological upgrading and/or need for surgical intervention) groups. Multivariable Cox regression was performed to identify independent predictors of hernia development and progression. Results A total of 361 patients were included in this study. The incidence of radiological PSH was 30%, graded as I (56.5%), II (12%) and III (31.5%). The median (interquartile range [IQR]) time to radiological hernia was 8 (5–15) months. During the median (IQR) follow‐up of 27 (13–47) months in 108 patients with a hernia, 26% patients progressed. The median (IQR) time to progression was 12 (6–21) months. On multivariable analysis, female gender (hazard ratio [HR] 1.86), diabetes (HR 1.81), chronic obstructive pulmonary disease (COPD; HR 1.78) and higher body mass index (BMI; HR 1.07 for each unit) were independent predictors for radiological PSH development. No significant factor was found to be associated with hernia progression. Conclusion Radiological PSH after RC and IC occurred in 30% of patients, a quarter of whom progressed in a median time of 12 months. Female gender, diabetes, COPD and high BMI were independent predictors for radiological hernia development.

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Section: Discussionmentioning

confidence: 76%

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

et al. 2021

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“…This may be because women have significantly thinner muscles and thicker subcutaneous fat than men, regardless of their age 37 . A study of radiologic predictors of PSH development after end colostomy found that abdominal adipose tissue volume ratio and total muscle mass density were significantly associated with the occurrence of PSH 38 . This physiological difference may make female patients more prone to developing PSH.…”

Section: Discussionmentioning

confidence: 99%

“…37 A study of radiologic predictors of PSH development after end colostomy found that abdominal adipose tissue volume ratio and total muscle mass density were significantly associated with the occurrence of PSH. 38 This physiological difference may make female patients more prone to developing PSH. At the same time, studies have found that most women increase their abdominal subcutaneous fat by more than 20% after menopause.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for parastomal hernia with a permanent colostomy

Liu

Zheng

Zhang

et al. 2022

Journal of Surgical Oncology

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Aim This study aims to explore the incidence and risk factors for permanent colostomy complicated with a parastomal hernia (PSH) after rectal cancer resection. Methods This was a retrospective study of gastrointestinal surgery performed from January 2013 to December 2017 in patients with colorectal cancer treated at the Affiliated Hospital of Qingdao University. The relevant clinical variables of the patient were analyzed. Kaplan–Meier, univariate, and Cox multivariate analyses were used to evaluate the influencing factors and morbidity of PSH. Results Among the 211 patients, 65 developed PSH. The cumulative incidence reached 33.5% at 62 months. In the multivariate Cox survival analysis, the results showed that being a woman, aged ≥65 years, having a body mass index (BMI) ≥ 25 kg/m2, diabetes, and Clavien–Dindo Grade III and IV complications were risk factors for the occurrence of PSH. Conclusion In our study, the incidence of PSH increased annually and reached a maximum of 33.5% after 62 months. Among the patient‐related factors, female sex, age ≥65 years, BMI ≥ 25 kg/m2, diabetes, and postoperative Clavien–Dindo Grade III and IV complications were significantly associated with the development of PSH. Therefore, intervention measures to prevent patients with this risk factor are advisable.

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“…These hernias are considered different from mucosal prolapse or a Siphon loop, considered a subcutaneous folding of the exceeding bowel length at the stoma [22]. According to Pennings and coworkers [23], chronic obstructive pulmonary disease, longer operation time, and larger abdominal wall defects at the colostomy site (> 34 mm) can predict the development of parastomal hernias.…”

Section: Parastomal Wall Herniasmentioning

confidence: 99%

Pre- and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification

et al. 2021

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Abdominal wall hernias are common and can present as technical challenges to surgeons. When large, hernias diminish quality of life. Various classifications of incisional hernias have been proposed; however, there are many terms, sometimes causing confusion (1). Radiologists must know the normal anatomy of the abdominal wall, the CT protocol, and what if any maneuvers can be performed to better identify an abdominal wall defect. The description of the radiological approach for primary and incisional wall hernias is based on the 2007 European Hernia Society classification, with particular emphasis on presurgical and postsurgical imaging findings. This classification provides a simple and reproducible method to describe hernias to offer proper surgical management. We highlight this classification so that radiologists and surgeons can have a unified language.

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Clinical and Radiologic Predictors of Parastomal Hernia Development After End Colostomy

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Cited by 21 publications

References 17 publications

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

Incidence and risk factors for parastomal hernia with a permanent colostomy

Pre- and postsurgical imaging findings of abdominal wall hernias based on the European Hernia Society (EHS) classification

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