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Risk factors for parastomal hernia after abdominoperineal resection for rectal cancer
Keita Kojima1, Takatoshi Nakamura1, Takeo Sato1
1Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Introduction:
This study was designed to identity risk factors for parastomal hernia occurring after abdominoperineal resection for rectal cancer.
Methods:
The study group was comprised of 158 patients with rectal cancer who underwent abdominoperineal resection in our department from January 1990 through December 2014. Twelve variables were studied as risk factors for parastomal hernia.
Results:
Parastomal hernia developed in 27 patients, including 19 patients who underwent colostomy creation via an intraperitoneal route and 8 patients who underwent colostomy creation via an extraperitoneal route. On univariate analysis, a BMI ≥25 kg/m2 was significantly related to the development of parastomal hernia (P = 0. 018), and an ASA physical status ≥2 was slightly but not significantly related to parastomal hernia (P = 0. 076). Multivariate analysis showed that a BMI ≥25 kg/m2 was an independent risk factor (odds ratio = 2.9698; P = 0. 016).
Conclusion:
Patients with a BMI ≥25 kg/m2 should be instructed about lifestyle modifications to control preoperative bodyweight and to reduce abdominal pressure.
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