The Risk Factors for Parastomal Hernia Development: A 8-year Retrospective Study in Colorectal Surgery

Abstract

Background: Although parastomal hernia is a common complication of ostomy surgery, the exact risk factors for its development remain unclear. The aim of this study was to determine the incidence and risk factors of parastomal hernia in ostomy patients. 
 Methods: A retrospective study was conducted. The data from a cohort of 952 ostomy patients' hospital records between 2013 and 2020 were extracted and analyzed. Patients’ ostomy-related characteristics, complication notes, and the occurrence of parastomal hernia were retrieved. 
 Results: The patients' mean age was 59.6 years (±14.4 years), and 524 (55%) of them were male. Colorectal cancer (476 patients,50%) was the most common etiology for surgery. Parastomal hernia developed in 100 (10.5%) of patients. Age >65 (OR=1.753; 95%CI=1.071-2.869), BMI >24.9 (OR=2.009; 95%CI=1.201-3.362), co-morbidity (OR=1.773; 95%CI=1.021-3.080), laparoscopic surgery (OR=5.643; 95%CI=3.113-10.230), height of ostomy (OR=1.906; 95%CI=1.122-3.236), left lower quadrant ostomy location (OR=2.252; 95%CI=1.319-3.845), prolapse (OR=7.876; 95%CI=3.571-17.372), and other ostomy-related complications (OR=2.888; 95%CI=1.179-7.074) were risk factors based on logistic regression analysis. 
 Conclusion: The incidence of parastomal hernia was nearly one in ten patients after colorectal surgery with an ostomy. Advanced age, co-morbidity, laparoscopic surgery, the height of the ostomy, the left lower quadrant ostomy location, prolapse, and other ostomy-related complications were independent risk factors.