Relationship between stoma creation route for end colostomy and parastomal hernia development after laparoscopic surgery



The therapeutic benefits of extraperitoneal colostomy with laparoscopic surgery remain unclear. The aim of this study was to investigate the relationship between the route for stoma creation with laparoscopic surgery and stoma-related complications, especially parastomal hernia (PSH).


From January 2007 to March 2015, a total of 59 patients who underwent laparoscopic abdominoperineal resection or Hartmann procedure were investigated. Patient demographic and treatment characteristics, including stoma-related complications, were analyzed retrospectively.


Transperitoneal and extraperitoneal colostomy were performed in 29 and 30 patients, respectively. Median follow-up duration was 21 months (range: 2–95). Patient demographic and treatment characteristics were comparable between the transperitoneal group (TPG) and the extraperitoneal group (EPG). PSH developed in 12 (41 %) patients in TPG, and 4 (13 %) patients in EPG (p = 0.020). The incidence of other stoma-related complications and non-stoma-related complications did not differ significantly between TPG and EPG. No patient characteristics except for transperitoneal route for stoma creation were associated with PSH development.


The extraperitoneal route for stoma creation is associated with a significantly lower incidence of PSH development after laparoscopic surgery. Whenever possible, extraperitoneal colostomy should be recommended, even with laparoscopic surgery.

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Correspondence to Tomohiro Yamaguchi.

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Hitoshi Hino, Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Masakatsu Numata, Akinobu Furutani, Takuya Suzuki, and Kakeru Torii have no conflicts of interest or financial ties to disclose.

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Hino, H., Yamaguchi, T., Kinugasa, Y. et al. Relationship between stoma creation route for end colostomy and parastomal hernia development after laparoscopic surgery. Surg Endosc 31, 1966–1973 (2017).

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  • Parastomal hernia
  • Extraperitoneal route
  • Transperitoneal route
  • Laparoscopic surgery
  • Abdominoperineal resection
  • Hartmann procedure