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Published on: September 11, 2021
Incidence of Parastomal Hernia: A Descriptive, Retrospective Study
Maria-Elena García-Manzanares1,2,3,4,5,6,7, Maria-Consuelo Arellano-Requena1,2,3,4,5,6,7, Francisco-Javier Borda-García1,2,3,4,5,6,7
1Maria-Elena García-Manzanares, RN, MSN, Department of General Surgery, Digestive System and Abdominal Organ Transplant Service, University Hospital 12 de Octubre; Department of Nursing, Faculty of Nursing, Complutense University of Madrid; Institute of Health Research Hospital 12 de Octubre (imas12), Madrid, Spain.
Purpose:
The objectives of this study were to determine the incidence of parastomal hernia (PSH) in ostomy patients, define their sociodemographic and clinical profile, establish the time of PSH appearance following ostomy surgery, and identify related symptoms.
Design:
Descriptive longitudinal retrospective study.
Subjects And Setting:
The target population was non-hospitalized patients followed by an ostomy nurse specialist for more than 6 months in an ostomy clinic located in a tertiary hospital in Madrid, Spain. The sample comprised 360 persons with an ostomy; their mean age was 66.33 (SD 13.74) years; a slight majority 56.45% (n = 197) were men.
Methods:
We retrospectively reviewed the medical records of patients who underwent ostomy surgery between January 2015 and December 2019. Sociodemographic and relevant clinical variables, reported symptoms, and use and perception of an abdominal compression binder, and the characteristics of PSH in patients with PSH were collected. The diagnosis of PSH was made by CT scan, physical examination, or a combination of both techniques.
Results:
A majority of participants (71.7%, n = 258) underwent ostomy surgery to manage a malignancy; most (65.8%, n = 237) had not undergone previous abdominal surgeries. More than half (68.69%, n = 248) had comorbid conditions such as hypertension, thyroid disorders, dyslipidemia, cardiopathy, Parkinson disease, additional types of cancer such as breast, prostate and lung, depression, anxiety, benign prostatic hyperplasia/prostatic enlargement, or chronic kidney disease. Less than 1 in 10 (8.6%, n = 31) underwent intraoperative prophylactic mesh placement during ostomy surgery. Stoma site marking was performed in 44.7% (n = 161), and preoperative education with the ostomy nurse specialist was documented in 39.2% (n = 141). Presence of a PSH was determined by abdominal CT scan in 135 (37.5%), versus 41.49% (n = 149) who had a PSH detected by physical examination alone. Parastomal hernia severity was classified in 51.01% (n = 76) of cases; 81.57% (n = 62) were type I or III, based on the European Hernia Society classification system. The mean time of development of PSH was 8.57 (SD 6.09) months.
Conclusion:
In this study, patients with PSH were older and had more associated comorbidities. They had PSH-related discomfort and did not use an abdominal compression binder because it was uncomfortable.
