Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Tivenius, Mathilda; Näsvall, Pia; Sandblom, Gabriel

doi:10.1007/s00384-019-03292-4

Cited by 13 publications

(17 citation statements)

References 38 publications

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“…Parastomal hernia (PSH) is an incisional hernia at the stoma site. The incidence of PSH varies from 3% to 50% because of heterogeneities in the definition of PSH, diagnos-tic modalities (clinical or radiological), patient population, stoma type, and follow-up duration [32][33][34][35][36]. The incidence of PSH increases over time and is more than 30%, 40%, and 50% by 1 year, 2 years, and longer follow-up durations, respectively [33].…”

Section: Parastomal Herniamentioning

confidence: 99%

“…However, the nonoperative treatment of PSH has a lower cross-over rate (21%) than the surgical treatment, most of which is not emergency surgery [37]. Moreover, a recent nation-wide cohort study showed that the cumulative incidence of PSH causing symptoms or requiring surgery after 5 years is only 7.7% [36]. Therefore, surgical intervention for PSH should be solely indicated for symptomatic patients, and the relatively high morbidity (13%), mortality (6.3%), and recurrence (11% at 3 years) rates [40] must be informed to the patients before the treatment.…”

Section: Parastomal Herniamentioning

confidence: 99%

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Current Management of Intestinal Stomas and Their Complications

Tsujinaka

Tan

Miyakura

et al. 2020

J Anus Rectum Colon

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Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the "principles of perioperative patient management" section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the "early complications" section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the "late complications" section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre-and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.

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Section: Parastomal Herniamentioning

confidence: 99%

Section: Parastomal Herniamentioning

confidence: 99%

Current Management of Intestinal Stomas and Their Complications

Tsujinaka

Tan

Miyakura

et al. 2020

J Anus Rectum Colon

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“…Previous population-based studies [9,[14][15][16][17]] applied a restrictive approach to surgical treatment of parastomal bulging, and none of the studies [9,[14][15][16][17][18] provide knowledge on the course of treatment for patients already diagnosed with a parastomal bulge. When considering surgical correction, a wide range of treatment options should be looked at.…”

Section: Introductionmentioning

confidence: 99%

“…Patients' symptoms are likely to be overlapping [1,5] and affect their everyday lives [6] and health-related quality of life [7]. The reported proportion of patients undergoing surgery for parastomal bulging varies [5,[8][9][10][11], reflecting differences in definitions of parastomal bulging [2], incident cases [9,10,12] and local approaches [13].…”

Section: Introductionmentioning

confidence: 99%

Surgical repair of parastomal bulging: a retrospective register‐based study on prospectively collected data

et al. 2020

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Aim The aim of this work was to examine (1) the incidence of primary repair, (2) the incidence of recurrent repair and (3) the types of repair performed in patients with parastomal bulging. Method Prospectively collected data on parastomal bulging from the Danish Stoma Database were linked to surgical data on repair of parastomal bulging from the Danish National Patient Register. Survival statistics provided cumulative incidences and time until primary and recurrent repair. Results In the study sample of 1016 patients with a permanent stoma and a parastomal bulge, 180 (18%) underwent surgical repair. The cumulative incidence of a primary repair was 9% [95% CI (8%; 11%)] within 1 year and 19% [95% CI (17%; 22%)] within 5 years after the occurrence of a parastomal bulge. We found a similar probability of undergoing primary repair in patients with ileostomy and colostomy. For recurrent repair, the 5-year cumulative incidence was 5% [95% CI (3%; 7%)]. In patients undergoing repair, the probability was 33% [95% CI (21%; 46%)] of having a recurrence requiring repair within 5 years. The main primary repair was open or laparoscopic repair with mesh (43%) followed by stoma revision (39%). Stoma revision and repair with mesh could precede or follow one another as primary and recurrent repair. Stoma reversal was performed in 17% of patients. Conclusion Five years after the occurrence of a parastomal bulge the estimated probability of undergoing a repair was 19%. Having undergone a primary repair, the probability of recurrent repair was high. Stoma reversal was more common than expected.

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“…Ostomy even in the form of permanent or temporary is a routine practice in colorectal surgery in order to provide fecal diversion. 1 It is used for variety of conditions such as colorectal cancers, inflammatory bowel disease, diverticulitis, ischemic colitis, radiation colitis and fecal incontinence. Ostomy related morbidity and its function is highly related to the indication of operation, patient's body contouring, history of previous operations and whether the ostomy is created in elective or emergency condition.…”

Section: Introductionmentioning

confidence: 99%

Parastomal Hernia Following Abdominoperineal Resection

Bananzadeh

Jaweek

Rezazadehkermani

et al. 2020

Journal of Coloproctology

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Parastomal Hernia (PSH) is a common complication of patient who undergone ostomy especially end colostomy. Presence of hernia defect is associated with the risk of strangulation and obstruction so understanding the potential risk factor such as patient’s factor and technical issues is important. This study is evaluating the incidence of PSH hernia in patients who undergone end colostomy due to Abdominoperineal Resection (APR) in a tertiary colorectal surgery referral center and explore the possible risk factors of this complication. The study was designed as a retrospective cross sectional study on 41 patients who undergone end colostomy due to APR. Three patient lost the follow up and 13 patients died and 25 patients were enrolled in study. Demographic data, history of smoking, steroid administration, Diabetes, obstructive pulmonary disease, transfusion, Neoadjuvant therapy, wound infection and Body mass Index (BMI) were gathered. The mean age of participants was 58.8 and the mean BMI was 25.04 kg/m 2 . The incidence of PSH was 40% and 68% of operations were done with Laparoscopy. This study could not find statistically significant risk factor for PSH. The 40% incidence of PSH is noticeable and specific strategies should be applied to reduce such complications. Larger studies is essential to investigate the possible etiologies of this complication.

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Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Cited by 13 publications

References 38 publications

Current Management of Intestinal Stomas and Their Complications

Current Management of Intestinal Stomas and Their Complications

Surgical repair of parastomal bulging: a retrospective register‐based study on prospectively collected data

Parastomal Hernia Following Abdominoperineal Resection

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