Incidence and risk factors for parastomal hernia with a permanent colostomy

J Surg Oncol. 2022 Sep;126(3):535-543. doi: 10.1002/jso.26919. Epub 2022 May 24.

Abstract

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.

Keywords: colostomy; complication; incidence; parastomal hernia; risk factors.

MeSH terms

  • Colostomy / adverse effects
  • Colostomy / methods
  • Female
  • Hernia, Ventral* / epidemiology
  • Hernia, Ventral* / etiology
  • Hernia, Ventral* / prevention & control
  • Humans
  • Incidence
  • Incisional Hernia* / epidemiology
  • Incisional Hernia* / etiology
  • Retrospective Studies
  • Risk Factors
  • Surgical Mesh
  • Surgical Stomas* / adverse effects