Controllable Risk Factor in the Development of Parastomal Hernia Preoperative Marking

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Kozan R., Gültekin F. A.

Türk Kolon ve Rektum Hastalıkları Dergisi, vol.28, no.4, pp.172-176, 2018 (Peer-Reviewed Journal)


Aim: Parastomal hernia is one of the most common ostomy-related late complications. Understanding the factors that play a role in development is very important in terms of preventing this complication. In this study, we aimed to determine the factors associated with the development of parastomal hernia and to reveal the relationship between herniation and preoperative stoma site marking. Method: The data of 168 patients who underwent colostomy in our clinic were evaluated retrospectively. Demographic data, body mass index (BMI), malignant or benign disease status, emergency or elective operation, colostomy type, and preoperative stoma site marking were examined. Predictive factors in hernia development were determined by comparing patients with and without parastomal hernia. Results: When the data of 168 patients were examined, the mean age was 59±26.2 years, the female/male ratio was 81/87, and the mean BMI was 29.8±16.2 kg/m2. One hundred eighteen patients (70.2%) had colostomy due to malignancy, and 50 (29.8%) had colostomy due to benign causes. Sixty-three patients (37.5%) were operated under urgent conditions while 105 (62.5%) had elective surgery. Loop colostomy was performed in 40 patients (23.8%) and end colostomy was performed in 128 patients (76.2%). One hundred six patients (63.1%) had preoperative stoma site marking, but 62 (36.9%) were not marked. The incidence of parastomal hernia in the study was 5.95%. Median follow-up was 18 months (11-29 months). Conclusion: High BMI, emergency surgery, end colostomy, and not having preoperative stoma site marking were independent predictive risk factors for parastomal hernia development. Of these, the only controllable factor is preoperative marking. Performing preoperative stoma site marking in all possible cases will contribute to reducing the risk of parastomal hernia.