Risk factors for parastomal hernia after abdominoperineal resection for rectal cancer.
BACKGROUND
This study was designed to identity risk factors for parastomal hernia occurring after abdominoperineal resection for rectal cancer.


METHODS
The study group was comprised of 158 patients with rectal cancer who underwent abdominoperineal resection in our department from January 1990 through December 2014. Twelve variables were studied as risk factors for parastomal hernia.


RESULTS
Parastomal hernia developed in 27 patients, including 19 patients who underwent colostomy creation via an intraperitoneal route and 8 patients who underwent colostomy creation via an extraperitoneal route. On univariate analysis, a BMI ≥25 kg/m2was significantly related to the development of parastomal hernia (P = 0. 018), and an ASA physical status ≥2 was slightly but not significantly related to parastomal hernia (P = 0. 076). Multivariate analysis showed that a BMI ≥25 kg/m2was an independent risk factor (odds ratio = 2.9698; P = 0. 016).


CONCLUSIONS
Patients with a BMI ≥25 kg/m2should be instructed about lifestyle modifications to control preoperative bodyweight and to reduce abdominal pressure.
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Keita
K
Kojima
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Takatoshi
T
Nakamura
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Takeo
T
Sato
Kitasato University School of Nursing, Sagamihara, Japan.
Yasumi
Y
Matsubara
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Masanori
M
Naito
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Keishi
K
Yamashita
Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
Masahiko
M
Watanabe
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology*; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010502:Perineum / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors
Abdominoperineal resection; parastomal hernia; rectal cancer