Preventing parastomal hernia with modified stapled mesh stoma reinforcement technique (SMART) in patients who underwent surgery for rectal cancer: a case–control study

Ikeda²,

et al. 2020

Preprint

Section: Discussionmentioning

confidence: 99%

Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery

Ikeda²,

et al. 2020

Preprint

“…These new findings provide important information for performance of optimal laparoscopic surgery. An understanding of risk factors for parastomal hernia is important because this can decrease the incidence of complications, contribute to improved QOL, and reduce medical costs [7][8][9]. A stoma that was not formed through the middle of the rectus abdominis muscle was found to be a risk factor for parastomal hernia, and a laparoscopic approach was associated with this risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…Parastomal hernia is a common stoma-related complication with a reported incidence of up to 81%, and this complication induces other stoma-related complications, affects quality of life (QOL), and increases financial costs in the healthcare system [7][8][9]. This incidence has changed little despite advances in surgical techniques and instruments.…”

Section: Introductionmentioning

confidence: 99%

“…This incidence has changed little despite advances in surgical techniques and instruments. Techniques for preventing parastomal hernia formation, such as formation of a lateral rectus abdominis-positioned stoma and stapled mesh stoma reinforcement, have been reported [9][10][11]. However, these methods are not commonly used because many surgeons recognize that a stoma that passes through the rectus abdominis muscle sheath reduces parastomal hernia formation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery

Ikeda²,

et al. 2019

Preprint

KEYWORDS laparoscopic surgery, parastomal hernia, peristomal skin disorders, risk factors, stoma-related complications 2 Abstract Purpose: 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 or open loop stoma, 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 cases with stoma creation in loop ileostomy or colostomy performed 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. In univariate analysis, a stoma that did not pass through the middle of the rectus abdominis muscle was a significant risk factor for parastomal hernia. This remained as the only independent risk factor for parastomal hernia formation in multivariate analysis. An additional analysis identified a laparoscopic approach as the only independent risk factor for formation of a stoma that did not pass through the middle of the rectus abdominis muscle. An analysis of stomarelated complications showed that peristomal skin disorders were significantly associated with parastomal hernia formation. 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, and that a laparoscopic approach is associated with this risk factor. Moreover, a parastomal hernia is significantly associated with peristomal skin disorders.

“…Parastomal hernia is a common stoma-related complication with a reported incidence of up to 81%, and this complication induces other stoma-related complications, affects quality of life (QOL), and increases nancial costs in the healthcare system [7][8][9]. This incidence has changed little despite advances in surgical techniques and instruments.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era

Ikeda²,

et al. 2020

Preprint

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.