Controllable Risk Factor in the Development of Parastomal Hernia; Preoperative Marking

• Published in: Turkish Journal of Colorectal Disease
• Main Authors: Ramazan Kozan, Fatma Ayça Gültekin
• Format: Article
• Language: English
• Published: Turkish Society of Colon and Rectal Surgery 2018-12-01
• Subjects: Parastomal hernia; stoma site marking; stoma complications
• Online Access: http://www.turkishjcrd.com/jvi.aspx?pdir=krhd&plng=eng&un=KRHD-35492

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, it was aimed to determine the factors that are effective in 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 datas, body mass index (BMI), malignant or benign disease status, emergency or elective operation, colostomy type and preoperative stoma site markings were examined. Predictive factors in hernia development were determined by comparing the patients with and without parastomal hernia. Results: When the data of 168 patients were examined, the mean age was 59 ± 26.2 year, the female/male ratio was 81/87, and the BMI average was 29.8 ± 16.2 kg/m2. 118 (70.2%) patients had colostomy due to malignancy, and 50 (29.8%) patients had colostomy due to benign causes. 63 (37.5%) patients were operated under urgent conditions while 105 (62.5%) patients were operated under elective conditions. Loop colostomy was performed in 40 (23.8%) patients and end colostomy was performed in 128 (76.2%) patients. 106 (63.1%) patients had preoperative stoma site marking, but 62 (36.9%) patients were not marked. The incidence of parastomal hernia in the study was 5.95%. Median follow-up was18 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.