Incidence and Risk Factors of Parastomal Hernia in Patients Undergoing Radical Cystectomy and Ileal Conduit Diversion

Abstract

We demonstrated that parastomal hernia will develop in nearly a third of patients after radical cystectomy with ileal conduit diversion. Prior laparotomy and severe obesity are independent risk factors. Preoperative counseling and preventative measures regarding parastomal hernia formation should be emphasized, particularly in these at risk patients.

Parastomal hernia after ileal conduit with a prophylactic mesh: a 10 year consecutive case series

“…Studies investigating the frequencies of PSH after ileal conduit without a prophylactic mesh have reported rates between 0 and 29% [4][5][6][7][8][9][10][11]. The reported frequencies appear to have increased over the past 40 years.…”

“…The use of computed tomography (CT) scan examinations has also been proposed to have increased the reported incidence of PSH in other types of ostomies [25]. However, only one study has consistently examined all patients with a CT scan when detecting PSH after an ileal conduit [4]. Recent studies on PSH after colostomies have Data are shown as mean ± SD or n (%).…”

“…Prior exploratory laparotomy and severe obesity have previously been found to be associated with an increased rate of PSH [4]. In other types of stomas obesity, wound infection, old age, corticosteroid use, chronic respiratory disorders and malnutrition are considered to be risk factors for PSH [25].…”

“…One of the most frequent complications of an ileal conduit diversion is the development of a parastomal hernia (PSH), reported to occur in 0-29.1% of the patients [4][5][6][7][8][9][10][11]. Within the field of colorectal surgery, similar figures have been reported on the rate of PSH after end ileostomies [12].…”

Ventral hernia: Patient selection, treatment, and management

“…If non-operative management is pursued in these patients, the risk of incarceration and requiring emergency surgery is increased at an estimated 2-3%/year (Table 1). [11][12][13][14][15][16] Nationally, the rate of emergency ventral hernia repair increased from 16.0% to 19.2% per 100,000 person-years in 2001 and 2010, respectively (p-value <0.05). 17 Outcomes of emergency surgery are dismal with increased risk of all complications including reoperation (RR 2.72, 95% CI 1.5-4.94), 30-day readmission (RR 1.61, 95% CI 1.23-2.11), and mortality (RR 13.1, 95% CI 6.39-26.86).…”