Incidence and risk factors for parastomal bulging in patients with ileostomy or colostomy: a register‐based study using data from the Danish Stoma Database Capital Region

Andersen, Rune Martens; Klausen, Tobias Wirenfeldt; Danielsen, Anne Kjærgaard; Vinther, Anders; Gögenur, Ismail; Thomsen, Thordis

doi:10.1111/codi.13907

Cited by 26 publications

(40 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, the cumulative incidence of stomal hernia requiring surgery or causing symptoms was 7.7% over a 5year follow-up period. Although this figure is lower than reported from previous studies using more sensitive methods and other criteria for determining the presence of stomal hernia [9,[27][28][29], the outcome in the present study focused on clinically relevant hernias.…”

Section: Discussioncontrasting

confidence: 69%

Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Tivenius

Näsvall

Sandblom

2019

Int J Colorectal Dis

View full text Add to dashboard Cite

Purpose Parastomal hernia is a complication with high morbidity that affects the patient's quality of life. The aim of this study was to assess the cumulative incidence of parastomal hernia in patients who have undergone colorectal cancer surgery and to identify potential risk factors that could predispose to the development of this type of hernia in a large population-based cohort over a long follow-up period. Methods The Swedish Colorectal Cancer Registry and the National Patient Register were used to collect study cohort data between January 2007 and September 2013. All patients undergoing colorectal cancer surgery including a permanent stoma were included in the study group. Results A total of 39,984 patients were registered during the study period. Of these, 7649 received a permanent stoma. Multivariate proportional hazard analysis, based on 6329 patients for whom all covariates could be retrieved, showed that the only independent risk factor for developing a parastomal hernia was BMI ≥ 30 (HR 1.49; 95% CI 1.02-2.17; p < 0.037). A slightly elevated hazard ratio was found for preoperative radiotherapy (HR 1.36; 95% CI 0.96-1.91; p < 0.070). The cumulative incidence of patients diagnosed or surgically treated for parastomal hernia over a follow-up period of 5 years was 7.7% (95% CI 6.1-9.2%). Conclusions The cumulative incidence of parastomal hernia causing symptoms or requiring surgery after 5 years was at least 7.7%. Obesity increases the risk of developing parastomal hernia.

show abstract

Section: Discussioncontrasting

confidence: 69%

Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Tivenius

Näsvall

Sandblom

2019

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

“…In rectal cancer, a stoma has commonly been used to prevent resultant clinical complications of AL, but the stoma itself can cause many complications [3,11]. The most common complication of the stoma is skin excoriation [3,12].…”

Section: Discussionmentioning

confidence: 99%

Ileostomy versus fecal diversion device to protect anastomosis after rectal surgery: a randomized clinical trial

Kim

Jung

Kim

2019

Int J Colorectal Dis

View full text Add to dashboard Cite

Purpose Patients with rectal anastomosis commonly experience various ileostomy-related complications. This study aimed to elucidate the usefulness of a fecal diversion device (FDD) as an alternative to ileostomy for protecting rectal anastomosis. Methods Patients with rectal anastomosis were randomly assigned to the ileostomy and FDD groups except in cases of emergency surgery. The primary endpoint was the clinical safety and effectiveness of FDD. The mean operation time, delay of diet advancement, length of hospital stay, FDD and stoma durations, and anastomotic leakage (AL) management methods were compared. Results A total of 54 patients were enrolled in this study. No cases of mortality occurred. Overall morbidity was similar between groups (P = 0.551). Six patients (22.2%) in the FDD group and nine (29.0%) in the stoma group (P = 0.555) had AL. The mean total hospital stay was 16.4 ± 6.7 and 23.4 ± 8.7 days in the FDD and stoma groups, respectively (P = 0.002). The mean total hospital cost was 12,726.8 ± 3422.8 USD and 17,954.9 ± 9040.3 USD in the FDD and stoma groups, respectively (P = 0.008). The mean FDD and stoma durations were 21.6 ± 6.1 days and 114.9 ± 41.3 days, respectively (P < 0.0001). Conclusions This study demonstrated FDD safety and effectiveness. We identified the possibility of FDD as an alternative technique to conventional stoma procedures.

show abstract

“…The strengths of this present study are the use of high‐quality national and regional registries and the long‐term follow‐up, enabling reflection of daily practice at a national level. Unfortunately, patient‐related risk factors such as smoking, alcohol consumption [3,41], previous surgery [17] and concomitant hernia were too infrequent to examine their potential impact on outcomes. We anticipate that comorbidity was incorporated into the decision on surgical repair in order to optimize results.…”

Section: Discussionmentioning

confidence: 99%

“…Asymptomatic bulges, small bulges or bulges in obese patients may go undetected, leading to potential underestimation, while symptomatic bulges may be more likely to undergo subsequent repair, leading to a potential overestimation of the incidence of repair. In addition, patients not attending follow‐up in the DSDCR may be more complex [3] and less likely to undergo repair. Some misclassification of the number of repairs is to be expected as we had no knowledge of repairs prior to the inclusion period.…”

Section: Discussionmentioning

confidence: 99%

Surgical repair of parastomal bulging: a retrospective register‐based study on prospectively collected data

et al. 2020

Self Cite

View full text Add to dashboard Cite

Aim The aim of this work was to examine (1) the incidence of primary repair, (2) the incidence of recurrent repair and (3) the types of repair performed in patients with parastomal bulging. Method Prospectively collected data on parastomal bulging from the Danish Stoma Database were linked to surgical data on repair of parastomal bulging from the Danish National Patient Register. Survival statistics provided cumulative incidences and time until primary and recurrent repair. Results In the study sample of 1016 patients with a permanent stoma and a parastomal bulge, 180 (18%) underwent surgical repair. The cumulative incidence of a primary repair was 9% [95% CI (8%; 11%)] within 1 year and 19% [95% CI (17%; 22%)] within 5 years after the occurrence of a parastomal bulge. We found a similar probability of undergoing primary repair in patients with ileostomy and colostomy. For recurrent repair, the 5-year cumulative incidence was 5% [95% CI (3%; 7%)]. In patients undergoing repair, the probability was 33% [95% CI (21%; 46%)] of having a recurrence requiring repair within 5 years. The main primary repair was open or laparoscopic repair with mesh (43%) followed by stoma revision (39%). Stoma revision and repair with mesh could precede or follow one another as primary and recurrent repair. Stoma reversal was performed in 17% of patients. Conclusion Five years after the occurrence of a parastomal bulge the estimated probability of undergoing a repair was 19%. Having undergone a primary repair, the probability of recurrent repair was high. Stoma reversal was more common than expected.

show abstract

Incidence and risk factors for parastomal bulging in patients with ileostomy or colostomy: a register‐based study using data from the Danish Stoma Database Capital Region

Abstract: Parastomal bulging is a common complication affecting one in three patients within 1 year of surgery. Along with previous findings, there is now considerable evidence for age and colostomy as being risk factors for parastomal bulging.

Cited by 26 publications

References 46 publications

Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Ileostomy versus fecal diversion device to protect anastomosis after rectal surgery: a randomized clinical trial

Surgical repair of parastomal bulging: a retrospective register‐based study on prospectively collected data

Contact Info

Product

Resources

About