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Increased risk of incisional hernia after stoma closure in patients with colorectal cancer

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Abstract

Purpose

Stoma construction and closure are common surgical strategies in patients with colorectal cancer. The present study evaluated the influence of multiple incisional sites resulting from stoma closure on incisional hernia after colorectal cancer surgery.

Methods

The study included 1681 patients who underwent colorectal cancer surgery. Multiple incisional sites were defined as the coexistence of incisions at the midline and stoma closure sites. We retrospectively investigated the relationship between the presence of multiple incisional sites and incisional hernia development in patients with colorectal cancer.

Results

Among the 1681 patients, 420 (25%) underwent stoma construction, with a stoma closure-to-construction ratio of 33% (139/420), and 155 (9.2%) developed incisional hernias after colorectal cancer surgery. In the multivariate analysis, female sex (p < 0.001), body mass index (p < 0.001), multiple incisional sites (p = 0.001), wound infection (p = 0.003), and postoperative chemotherapy (p = 0.030) were independent predictors of incisional hernia. In the multiple incisional sites group, the age (p < 0.001), surgical approach (laparoscopic) (p = 0.013), wound infection rate (p = 0.046), small bowel obstruction rate (p < 0.001), and anastomotic leakage rate (p = 0.008) were higher in those in the single incisional site group.

Conclusions

Multiple incisional sites resulting from stoma closure are associated with the development of incisional hernia following colorectal cancer surgery.

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Abbreviations

APR:

Abdominoperineal resection

AR:

Anterior resection

ASA-PS:

American Society of Anesthesiologists physical status

BMI:

Body mass index

HO:

Hartmann’s operation

IH:

Incisional hernia

ISR:

Intersphincteric resection

PO:

Palliative operation

TP:

Total proctocolectomy

TPE:

Total pelvic exenteration

RHC:

Right hemicolectomy

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Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Naoki Takada, Yasuhiro Takano, Atsuko Okamoto, Takafumi Nakano, Yuta Imaizumi, Hiroshi Sugano, Yasuhiro Takeda, Masahisa Ohkuma, Makoto Kosuge & Ken Eto

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  1. Naoki Takada
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  2. Yasuhiro Takano
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Correspondence to Yasuhiro Takano.

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The authors declare no conflicts of interest. The manuscript was not prepared or funded by any commercial organization. The present study was approved by the Institutional Ethics Committee of Jikei University School of Medicine and conformed to the ethical guidelines of the Declaration of Helsinki.

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Takada, N., Takano, Y., Okamoto, A. et al. Increased risk of incisional hernia after stoma closure in patients with colorectal cancer. Surg Today (2024). https://doi.org/10.1007/s00595-024-02866-2

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