Incisional hernia following closure of loop ileostomy: The main predictor is the patient, not the surgeon

Brook, Allan; Mansfield, Scott; Daniels, Ian R.; Smart, Neil J.

doi:10.1016/j.surge.2016.03.004

Cited by 27 publications

(31 citation statements)

References 14 publications

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supporting

confidence: 48%

“…It is interesting that hypertension is associated with abdominal wall failure, a relationship previously identified in our own work following loop ileostomy closure. The significance of BMI and hypertension appear to be overtaking smoking as a risk factor, as smoking was not a significant factor in this analysis or others. Optimizing BP and weight reduction are logical ways to reduce the incidence of hernia, as well as the selective use of prophylactic mesh implants in high‐risk patients.…”

mentioning

confidence: 59%

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Incidence of and risk factors for stoma‐site incisional herniation after reversal

et al. 2019

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supporting

confidence: 48%

mentioning

confidence: 59%

Incidence of and risk factors for stoma‐site incisional herniation after reversal

et al. 2019

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“…Twenty studies did not mention detection methods and, therefore, it seems likely to assume that imaging was not used in these studies. To investigate potential underestimation, the overall incidence of SSIH from the 11 studies with SSIH as the primary outcome was calculated (17.7%, range 1.7%–36.1%) . These rates indeed support the hypothesis that the overall incidence of hernia from all included studies (6.5%), as from those only reporting on SSIH as a secondary outcome (3.6%), is an underestimation.…”

Section: Discussionmentioning

confidence: 76%

“…Eight studies reported on risk factors for development of SSIH (Table ) . In univariate analysis, Brook et al .…”

Section: Resultsmentioning

confidence: 99%

“…Temporary stomas are frequently constructed to defunction a low colorectal anastomosis and during surgery for acute complicated diverticulitis, inflammatory bowel disease and traumatic intestinal injury [1][2][3][4][5][6][7][8]. Subsequent stoma reversal is associated with surgical site infection (SSI), anastomotic leakage, postoperative ileus and development of stoma site or midline incisional hernia (MIH) [9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta‐analysis

et al. 2018

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Hernia at the stoma site after loop ileostomy reversal

Eklöv

Viktorsson

Frosztega

et al. 2020

Int J Colorectal Dis

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Purpose To estimate the incidence of and risk factors for stoma site hernia after closure of a temporary diverting ileostomy. Method In a non-comparative cohort study, charts (n = 216) and CT-scans (n = 169) from patients who had undergone loop ileostomy closure following low anterior resection for rectal cancer 2010-2015 (mainly open surgery) at three hospitals were evaluated retrospectively. Patients without hernia diagnosis were evaluated cross-sectionally through a questionnaire (n = 158), and patients with symptoms of bulging or pain were contacted and offered a clinical examination or a CT scan including Valsalva maneuver. Results In the chart review, five (2.3%) patients had a diagnosis of incisional hernia at the previous stoma site after 8 months (median). In 12 patients, the CT scan showed a hernia, of which 8 had not been detected previously. The questionnaire was returned by 130 (82%) patients, of which 31% had symptoms of bulging or pain. Less than one in five of patients who reported bulging were diagnosed with hernia, but the absolute majority of the radiologically diagnosed hernias reported symptoms. By combining clinical and radiological diagnosis, the cumulative incidence of hernia was 7.4% during a median follow up time of 30 months. Risk factors for stoma site hernia were male sex and higher BMI. Conclusion Hernia at the previous stoma site was underdiagnosed. Less than a third of symptomatic patients had a hernia diagnosis in routine follow up. Randomized studies are needed to evaluate if prophylactic mesh can be used to prevent hernias, especially in patients with risk factors.

show abstract

Incisional hernia following closure of loop ileostomy: The main predictor is the patient, not the surgeon

Cited by 27 publications

References 14 publications

Incidence of and risk factors for stoma‐site incisional herniation after reversal

Incidence of and risk factors for stoma‐site incisional herniation after reversal

Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta‐analysis

Hernia at the stoma site after loop ileostomy reversal

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