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Risk Factors for Parastomal Hernia Associated with Covering Stoma in Rectal Surgery

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Abstract

The definitive risk factors for parastomal hernia (PSH), a complication of stoma construction that can lead to severe morbidity, remain unclear. Therefore, this study aimed to determine risk factors for PSH after rectal surgery in Japanese patients. We retrospectively included 134 patients who underwent rectal tumor surgery and covering stoma construction between January 2012 and October 2016 in our department. Eleven variables, including the presence of sarcopenia determined by computed tomography (CT), were studied as risk factors for PSH. The diagnosis of PSH was based on CT obtained during follow-up after surgery. Our results indicated that the incidence of PSH was 16.4% (22/134). Multivariate analysis revealed that age ≥ 65 years (odds ratio [OR], 9.53; 95% confidence interval [CI], 2.11–71.3; P = 0.009), sarcopenia (OR, 5.08; 95%CI, 1.10–25.8; P = 0.039), umbilical subcutaneous fat thickness ≥ 21.3 mm (OR, 7.91; 95%CI, 2.02–38.9; P = 0.0051), and colostomy (OR, 9.02; 95%CI, 1.58–64.3; P = 0.018) were independent risk factors for PSH. Therefore, older age, sarcopenia, thick subcutaneous fat, and colostomy were risk factors for PSH. With the increasing age and sarcopenia incidence in recent years, reduction of risk factors and preventative approaches for PSH are necessary before rectal surgery.

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Availability of Data and Material

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This research is supported by Grants-in-Aid for Scientific Research (C grant number 18K07194; C grant number 19K09114; C grant number 19K09115; C grant number 20K09051; Challenging Research (Exploratory) grant number 20K21626) from Japan Society for the promotion of Science.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kazuhiro Ishimaru, Yasutaka Shuno, Hiroaki Nozawa, Kazushige Kawai, Koji Murono & Soichiro Ishihara

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  1. Kazuhiro Ishimaru
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  2. Yasutaka Shuno
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  3. Hiroaki Nozawa
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  4. Kazushige Kawai
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  5. Koji Murono
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  6. Soichiro Ishihara
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Contributions

Kazuhiro Ishimaru and Yasutaka Shuno designed the study and wrote the initial draft of the manuscript. Soichiro Ishihara contributed to data analysis and interpretation. Hiroaki Nozawa, Kazushige Kawai, and Koji Murono have contributed to data collection. Hiroaki Nozawa, Kazushige Kawai, Koji Murono, and Soichiro Ishihara critically reviewed the manuscript. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Kazuhiro Ishimaru.

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This study was approved by the Ethics Committee of the University of Tokyo (No. 3252-(8)).

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Ishimaru, K., Shuno, Y., Nozawa, H. et al. Risk Factors for Parastomal Hernia Associated with Covering Stoma in Rectal Surgery. Indian J Surg 83 (Suppl 3), 749–754 (2021). https://doi.org/10.1007/s12262-021-02803-4

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  • DOI: https://doi.org/10.1007/s12262-021-02803-4

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