title: Risk factors for parastomal hernia in Japanese patients with permanent colostomy.
abstract: OBJECTIVE
  Although the definitive risk factors for parastomal hernia development remain unclear, potential contributing factors have been reported from Western countries. The aim of this study was to identify the risk factors for parastomal hernia in Japanese patients with permanent colostomies.
  
  
  METHODS
  All patients who received abdominoperineal resection or total pelvic exenteration at our institution between December 2004 and December 2011 were reviewed. Patient-related, operation-related and postoperative variables were evaluated, in both univariate and multivariate analyses, to identify the risk factors for parastomal hernia formation.
  
  
  RESULTS
  Of the 80 patients who underwent colostomy, 22 (27.5 %) developed a parastomal hernia during a median follow-up period of 953 days (range 15-2792 days). Hernia development was significantly associated with increasing patient age and body mass index, a laparoscopic surgical approach and the transperitoneal route of colostomy formation. In the multivariate analysis, the body mass index (p = 0.022), the laparoscopic approach (p = 0.043) and transperitoneal stoma creation (p = 0.021) retained statistical significance.
  
  
  CONCLUSIONS
  Our findings in Japanese ostomates match those from Western countries: a higher body mass index, the use of a laparoscopic approach and a transperitoneal colostomy are significant independent risk factors for parastomal hernia formation. The precise role of the stoma creation route remains unclear.
authors.affiliation: Department of General and Gastroenterological Surgery, Toho University Medical Center Omori Hospital, 6-11-1 Omorinishi Otaku, Tokyo, 143-8541, Japan, kingkong@med.toho-u.ac.jp.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Funahashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nagashima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsuda
authors.forename: Junichi
authors.initials: J
authors.lastname: Koike
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shiokawa
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Ushigome
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Arai
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kaneko
authors.forename: Akiharu
authors.initials: A
authors.lastname: Kurihara
authors.forename: Hironori
authors.initials: H
authors.lastname: Kaneko
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D003125:Colostomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D054047:Surgical Stomas / Q000009:adverse effects*; D013997:Time Factors
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