Parastomal hernia. A study of the French federation of ostomy patients

Ripoche, J.; Basurko, Célia; Fabbro-Perray, P.; Prudhomme, Michel

doi:10.1016/j.jviscsurg.2011.10.006

Cited by 115 publications

(121 citation statements)

References 37 publications

(38 reference statements)

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“…Our findings are concordant with others that have found increasing rates of PH after cystectomy and colorectal resections in patients with elevated BMI. While malnutrition has been reported previously as a risk factor for PH development 24 , this is the first report to our knowledge to identify a quantifiable variable, preoperative albumin level, that is significantly associated with PH development.. Like other investigators analyzing factors associated with hernia formation, we found female gender was significantly associated with PH development. 25,26 Similar to Klein and colleagues, we did not find an association between the type of stoma (end-versus Turnbull loop stoma) and the risk of developing a PH after ileal conduit.…”

Section: Discussionsupporting

confidence: 63%

“…Radiographic diagnosis is typically more sensitive, generally associated with higher detection rates, and may lead to a greater identification of clinically insignificant hernias. 24 The length of follow-up probably impacts the rates of PH with the lowest published PH rates seen in studies with the shortest follow-up. 8 The median follow-up for patients who did not develop a PH was 12 months.…”

Section: Discussionmentioning

confidence: 99%

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1759 Risk Factors for the Development of Parastomal Hernia After Radical Cystectomy

et al. 2013

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Purpose-Parastomal hernia (PH) is a frequent complication from stoma formation after radical cystectomy (RC). We sought to determine the prevalence and risk factors for developing PH following RC.Material and Methods-Retrospective study of 433 consecutive patients who underwent open RC and ileal conduit between 2006-2010. Postoperative cross-sectional imaging studies performed for routine oncologic follow-up (n=1736) were evaluated for PH, defined as radiographic evidence of protrusion of abdominal contents through the abdominal wall defect created by forming the stoma. Univariable and multivariable Cox regression analyses were used to determine clinical and surgical factors associated with PH.Results-Complete data were available for 386 patients with radiographic PH occurring in 136. The risk of developing a PH was 27% (95% CI 22-33%) and 48% (95% CI 42-55%) at 1 and 2 years. Clinical diagnosis of PH was documented in 93 patients and 37 were symptomatic. Of 16 patients with clinical PH referred for repair, 8 had surgery. On multivariable analysis, female gender (HR=2.25, 95%CI 1.58-3.21; p<0.0001), higher BMI (HR=1.08 per unit increase 95%CI 1.05-1.12; p<0.0001), and lower preoperative albumin (HR=0.43 per g/dl, 95%CI 0.25-0.75; p=0.003) were significantly associated with PH.Conclusions-The overall risk of radiographic evidence of PH approached 50% at 2 years. Female gender, higher BMI, and lower preoperative albumin were most associated with developing PH. Identifying those at greatest risk may allow for prospective surgical maneuvers at the time of initial surgery, such as placement of prophylactic mesh in selected patients, to prevent the occurrence of PH.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

1759 Risk Factors for the Development of Parastomal Hernia After Radical Cystectomy

et al. 2013

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“…Broadly defined as an incisional hernia located at or immediately adjacent to a stoma, a parastomal hernia (PSH) develops in up to 78% of patients with a stoma and typically occurs within 2 years of ostomy creation but may develop as long as 20 or 30 years after surgery [7,10,11,12,13]. Goligher even went so far as to claim that some degree of parastomal herniation is inevitable given enough follow-up time [14].…”

Section: Definition and Incidencementioning

confidence: 99%

Parastomal Hernia: A Growing Problem with New Solutions

et al. 2014

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Parastomal hernia is one of the most common complications following stoma creation and its prevalence is only expected to increase. It often leads to a decrease in the quality of life for patients due to discomfort, pain, frequent ostomy appliance leakage, or peristomal skin irritation and can result in significantly increased healthcare costs. Surgical technique for parastomal hernia repair has evolved significantly over the past two decades with the introduction of new types of mesh and laparoscopic procedures. The use of prophylactic mesh in high-risk patients at the time of stoma creation has gained attention in lieu of several promising studies that have emerged in the recent days. This review will attempt to demonstrate the burden that parastomal hernias present to patients, surgeons, and the healthcare system and also provide an overview of the current management and surgical techniques at both preventing and treating parastomal hernias. i 2014 S. Karger AG, Basel

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“…Patient-related risk factors for parastomal hernia include female sex; age >60 years; obesity (waist circumference of >100 cm or body mass index of >25 kg/m 2 ); smoking; comorbidities such as hypertension, chronic respiratory disease, and ascites; poor nutritional status; inlammatory bowel disease; immunosuppression; corticosteroid use; postoperative sepsis; concomitant incisional hernia; and increases in intra-abdominal pressure [8,10,11,14,15]. Surgery or technique-speciic factors that should be taken into consideration include emergency stoma placement, the type of stoma (Table 1), surgical technique for ostomy construction, the diameter of the trephine, or size of the aperture in the abdominal wall, bringing the stoma out through the resection site, placement of prophylactic mesh, and position of the stoma [2,6,7,10,16].…”

Section: Incidence and Risk Factorsmentioning

confidence: 99%

“…The only drawback of using ePTFE meshes is the high infection risk when it is used in a contaminated ield [2,6,39,40]. Therefore, biological prostheses have gained popularity in PSH repair because of their resistance to mesh infection in potentially contaminated areas [3,14,36]. However, it cannot be concluded that biologic meshes are preferred over synthetic prostheses for reducing the rates of short-or long-term complications [36].…”

Section: Laparoscopic Repairmentioning

confidence: 99%

Parastomal Hernia

Çelik¹,

Kocaay²,

Akyol³

2017

Hernia

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Parastomal hernia (PSH) is a type of incisional hernia deined as a protrusion of abdominal contents through a weakness in the abdominal wall. PSH is the most common and signiicant complication following enterostomy construction, with an incidence of 30-50%. The risk is higher in colostomies than in ileostomies. Diagnosis of PSH is based on clinical examination or imaging. Most patients with PSH are usually asymptomatic. On the other hand, PSHs may afect an individual's physical function and decrease their quality of life. Surgical repair is indicated in 10-30% of patients with PSH. For repair, no single technique is superior to another. Therefore, several surgical methods have been developed and atempted, including primary repair, stoma relocation, and repair with diferent types of mesh either via the open or laparoscopic approach. However, high recurrence rates have been reported after repair. Because this is a diicult and problematic entity, the prevention of PSH occurrence is clearly the most appropriate management approach.

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Parastomal hernia. A study of the French federation of ostomy patients

Cited by 115 publications

References 37 publications

1759 Risk Factors for the Development of Parastomal Hernia After Radical Cystectomy

1759 Risk Factors for the Development of Parastomal Hernia After Radical Cystectomy

Parastomal Hernia: A Growing Problem with New Solutions

Parastomal Hernia

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