CC BY-NC-ND 4.0 · Journal of Coloproctology 2020; 40(04): 311-314
DOI: 10.1016/j.jcol.2020.06.011
Original Article

Parastomal Hernia Following Abdominoperineal Resection

Hérnia paraestomal após ressecção abdominoperineal
Alimohammad Bananzadeh
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Ibrahim Jaweek
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Leila Ghahramani
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Faranak Bahrami
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Seyed Vahid Hosseini
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
Ahmad Izadpanah
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
,
a  Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
› Author Affiliations

Abstract

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/m2. 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.

Resumo

A hérnia paraestomal é uma complicação comum em pacientes submetidos a estomia, especialmente a colostomia terminal. A presença de defeito de hérnia está associada ao risco de estrangulamento e obstrução, portanto, é importante compreender o potencial fator de risco, como o fator do paciente e questões técnicas. Este estudo avalia a incidência de hérnia paraestomal em pacientes submetidos à colostomia terminal devido à ressecção abdominoperineal em um centro terciário de referência em cirurgia colorretal e explorar os possíveis fatores de risco dessa complicação. O desenho do estudo foi transversal retrospectivo de 41 pacientes submetidos à colostomia terminal devido à ressecção abdominoperineal. Três pacientes foram perdidos no seguimento, 13 pacientes morreram, e 25 pacientes foram incluídos no estudo. Dados demográficos, história de tabagismo, administração de esteroides, diabetes, doença pulmonar obstrutiva, transfusão, terapia neoadjuvante, infecção de ferida operatória e Índice de Massa Corporal foram coletados. A média de idade dos participantes foi 58,8 e o índice de massa corporal médio foi 25,04 kg/m2. A incidência de hérnia paraestomal foi de 40% e 68% das cirurgias foram realizadas por laparoscopia. Este estudo não encontrou fator de risco estatisticamente significativo para hérnia paraestomal. A incidência de 40% de hérnia paraestomal é perceptível e estratégias específicas devem ser aplicadas para reduzir tais complicações. Estudos maiores são essenciais para investigar as possíveis etiologias dessa complicação.



Publication History

Received: 24 March 2020

Accepted: 07 June 2020

Publication Date:
08 March 2021 (online)

© 2020. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil