title: Incidence and risk factors of parastomal hernia.
abstract: OBJECTIVE
  Among the various stoma complications, the parastomal hernia (PSH) is the most common. Prevention of PSH is very important to improve the quality of life and to prevent further serious complications. The aim of this study was to analyze the incidence and the risk factors of PSH.
  
  
  METHODS
  From January 2002 and October 2008, we retrospectively reviewed 165 patients who underwent an end colostomy. As a routine oncologic follow-up, abdomino-pelvic computed tomography was used to examine the occurrence of the PSH. The associations of age, sex, body mass index (BMI), history of steroid use and comorbidities to the development of the PSH were analyzed. The median duration of the follow-up was 36 months (0 to 99 months).
  
  
  RESULTS
  During follow-up, 50 patients developed a PSH and the 5-year cumulative incidence rate of a PSH, obtained by using the Kaplan-Meier method, was 37.8%. In the multivariate COX analysis, female gender (hazard ratio [HR], 3.29; 95% confidence interval [CI], 1.77 to 6.11; P < 0.0001), age over 60 years (HR, 2.37; 95% CI, 1.26 to 4.46; P = 0.01), BMI more than 25 kg/m(2) (HR, 1.8; 95% CI, 1.02 to 3.16; P = 0.04), and hypertension (HR, 2.08; 95% CI, 1.14 to 3.81; P = 0.02) were all independent risk factors for the development of a PSH.
  
  
  CONCLUSIONS
  The 5-year incidence rate of a PSH was 37.8%. The significant risk factors of a PSH were as follows: female gender, age over 60 years, BMI more than 25 kg/m(2), and hypertension. Using a prophylactic mesh during colostomy formation might be advisable when the patients have these factors.
authors.affiliation: Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Yeun Ju
authors.initials: YJ
authors.lastname: Sohn
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Moon
authors.forename: Ui Sup
authors.initials: US
authors.lastname: Shin
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Jee