scholarly journals Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era

2020 ◽  
Author(s):  
Takuya Shiraishi ◽  
Yuji Nishizawa ◽  
Koji Ikeda ◽  
Yuichiro Tsukada ◽  
Takeshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Parastomal Hernia ◽  
Loop Ileostomy ◽  
Laparoscopic Approach ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Skin Disorders ◽  
Hernia Formation ◽  
Peristomal Skin

Abstract Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed.Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients who underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at our hospital from January to December 2016.Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the rectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p=0.005) during the median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing through the middle of the rectus abdominis muscle, the only independent factor associated with this misplacement of the stoma was a laparoscopic approach (p=0.012). An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia (p=0.049).Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk factor. Moreover, parastomal hernia is significantly associated with peristomal skin disorders.

scholarly journals Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era

2020 ◽  
Author(s):  
Takuya Shiraishi ◽  
Yuji Nishizawa ◽  
Koji Ikeda ◽  
Yuichiro Tsukada ◽  
Takeshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Parastomal Hernia ◽  
Loop Ileostomy ◽  
Laparoscopic Approach ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Skin Disorders ◽  
Hernia Formation ◽  
Peristomal Skin

Abstract Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed. Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients who underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at our hospital from January to December 2016. Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the rectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p=0.005) during the median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing through the middle of the rectus abdominis muscle, the only independent factor associated with this misplacement of the stoma was a laparoscopic approach (p=0.012). An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia (p=0.049). Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk factor. Moreover, a parastomal hernia is significantly associated with peristomal skin disorders.

scholarly journals Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery

2020 ◽  
Author(s):  
Takuya Shiraishi ◽  
Yuji Nishizawa ◽  
Koji Ikeda ◽  
Yuichiro Tsukada ◽  
Takeshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Parastomal Hernia ◽  
Independent Risk Factor ◽  
Laparoscopic Approach ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Hernia Formation ◽  
Peristomal Skin ◽  
Pass Through

Abstract Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open operations in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed.Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive cases with stoma creation in loop ileostomy or colostomy performed for any intra-abdominal condition at our hospital from January to December 2016.Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. In univariate analysis, a stoma that did not pass through the middle of the rectus abdominis muscle was a significant risk factor for parastomal hernia. This remained as the only independent risk factor for parastomal hernia formation in multivariate analysis. An additional analysis identified a laparoscopic approach as the only independent risk factor for formation of a stoma that did not pass through the middle of the rectus abdominis muscle. An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia formation.Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia, and that a laparoscopic approach is associated with this risk factor. Moreover, a parastomal hernia is significantly associated with peristomal skin disorders.

scholarly journals Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery

2019 ◽  
Author(s):  
Takuya Shiraishi ◽  
Yuji Nishizawa ◽  
Koji Ikeda ◽  
Yuichiro Tsukada ◽  
Takeshi Sasaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Parastomal Hernia ◽  
Independent Risk Factor ◽  
Laparoscopic Approach ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
Hernia Formation ◽  
Peristomal Skin ◽  
Pass Through

Abstract Purpose: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic or open loop stoma, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed. Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive cases with stoma creation in loop ileostomy or colostomy performed at our hospital from January to December 2016. Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. In univariate analysis, a stoma that did not pass through the middle of the rectus abdominis muscle was a significant risk factor for parastomal hernia. This remained as the only independent risk factor for parastomal hernia formation in multivariate analysis. An additional analysis identified a laparoscopic approach as the only independent risk factor for formation of a stoma that did not pass through the middle of the rectus abdominis muscle. An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia formation. Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia, and that a laparoscopic approach is associated with this risk factor. Moreover, a parastomal hernia is significantly associated with peristomal skin disorders.

scholarly journals The Presurgical Controlling Nutritional Status (CONUT) Score is Independently Associated with Severe Peristomal Skin Disorders: A Single-center Retrospective Cohort Study

2021 ◽  
Author(s):  
Takuya Shiraishi ◽  
Hiroomi Ogawa ◽  
Chika Katayama ◽  
Katsuya Osone ◽  
Takuhisa Okada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Nutritional Status ◽  
Laparoscopic Approach ◽  
Skin Disorders ◽  
Nutritional Interventions ◽  
Stoma Creation ◽  
Peristomal Skin ◽  
The Impact ◽  
Conut Score

Abstract Purpose: While nutritional interventions may potentially lower the risk of peristomal skin disorders (PSDs) and their exacerbation, no prior studies have evaluated the relationship between PSDs and nutritional status using the Controlling Nutritional Status (CONUT) score. Therefore, the purpose of this study was to assess the impact of preoperative nutritional status on stoma development, and determine risk factors for postoperative PSDs and their increased severity. Methods: A retrospective analysis was performed in 116 consecutive patients with rectal cancer who underwent radical surgery with stoma creation, including ileostomy and colostomy. Results: PSDs were diagnosed in 32 patients (27.6%); 10 (8.7%) cases were defined as severe based on the ABCD-stoma score. A multivariate analysis indicated that the laparoscopic approach (odds ratio [OR], 3.221; 95% confidence interval [CI], 1.001–10.362; P = 0.050) and ileostomy (OR, 3.394; 95% CI, 1.349–8.535; P = 0.009) were both independent risk factors for PSD. In a separate multivariate analysis for severe PSD, the only independent risk factor was the CONUT score (OR, 11.298; 95% CI, 1.382–92.373; P = 0.024). Conclusion: Severe PSDs are associated with preoperative nutritional disorders, as determined via the CONUT score. Furthermore, PSDs may potentially increase in severity, regardless of stoma type.

Risk factors for peristomal skin disorders associated with temporary ileostomy construction

Surgery Today ◽  
2021 ◽  
Author(s):  
Shingo Maeda ◽  
Akira Ouchi ◽  
Koji Komori ◽  
Takashi Kinoshita ◽  
Taihei Oshiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skin Disorders ◽  
Temporary Ileostomy ◽  
Peristomal Skin

scholarly journals Subcutaneous Onlay Laparoscopic Approach (SCOLA) for Umbilical Hernia with Diastasis of Rectus Abdominis Muscle: A Case Report

2021 ◽  
Author(s):  
Halil Afsin Tasdelen
Keyword(s):  
Umbilical Hernia ◽  
Video Clip ◽  
Laparoscopic Approach ◽  
Rectus Abdominis ◽  
High Recurrence Rate ◽  
Anatomical Landmarks ◽  
Rectus Abdominis Muscle ◽  
Hernia Defect ◽  
Diastasis Recti ◽  
Ventral Hernias

Abstract Diastasis of the rectus abdominis muscles (DRAM) is a common pathology, usually associated with midline abdominal wall hernias. The midline ventral hernias with diastasis have a significantly high recurrence rate, so repairing the hernia defect and the diastasis should be considered. Claus et al. previously described the subcutaneous onlay laparoscopic approach (SCOLA). We report a case of diastasis recti associated with umbilical hernia repaired with SCOLA technique. A 46-year-old male patient presented with a disturbing bulge in the upper midline and painful umbilical swelling. The CT scan followed by physical examination revealed 28 mm. umbilical hernia and 35 mm. diastasis recti. We aimed to introduce the SCOLA technique using a narrated video clip and showed all the critical steps and anatomical landmarks in the video. The postoperative period was uneventful, and the patient was discharged on the second postoperative day. The SCOLA technique is a feasible and reproducible alternative for the repair of midline hernias associated with DRAM.

scholarly journals Advanced T stage and thick rectus abdominis muscle triggers outlet obstruction and high-output stoma following ileostomy in patients with rectal cancer

2020 ◽  
Author(s):  
Yasuhiro Komatsu ◽  
Kunitoshi Shigeyasu ◽  
Yoshiko Mori ◽  
Kazutaka Takahashi ◽  
Nanako Hata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Outlet Obstruction ◽  
Muscle Thickness ◽  
Rectus Abdominis ◽  
Rectus Abdominis Muscle ◽  
T Stage ◽  
Common Risk Factors ◽  
Postoperative Problems ◽  
High Output

Abstract Background Ileostomy creation is an excellent approach to prevent leakage in patients undergoing low anterior resection for the treatment of rectal cancer. However, the two major complications of ileostomy are outlet obstruction and high-output stoma, and these complications remain unavoidable postoperative problems of ileostomy. Methods Risk factors associated with outlet obstruction and high-output stoma were retrospectively analyzed. The study included 83 patients with rectal cancer who underwent surgery. Of these patients, 34 underwent ileostomy creation. Results We found that outlet obstruction and high-output stoma were highly related (p = 0.03). Additionally, a thick rectus abdominis muscle and advanced T stage were the common risk factors of outlet obstruction (p = 0.0005 and p = 0.01, respectively) and high-output stoma (p = 0.04 and p = 0.03, respectively). Conclusions Our findings suggest that rectus abdominis muscle thickness and advanced T stage are predictive markers of outlet obstruction and high-output stoma.

Risk factors for the incidence and severity of peristomal skin disorders defined using two scoring systems

Surgery Today ◽  
2019 ◽  
Vol 50 (3) ◽  
pp. 284-291
Author(s):  
Takuya Shiraishi ◽  
Yuji Nishizawa ◽  
Mifumi Nakajima ◽  
Ryoko Kado ◽  
Koji Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoring Systems ◽  
Skin Disorders ◽  
Peristomal Skin

scholarly journals The presurgical controlling nutritional status (CONUT) score is independently associated with severe peristomal skin disorders: a single-center retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takuya Shiraishi ◽  
Hiroomi Ogawa ◽  
Chika Katayama ◽  
Katsuya Osone ◽  
Takuhisa Okada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Nutritional Status ◽  
Multivariable Logistic Regression Analysis ◽  
Skin Disorders ◽  
Nutritional Interventions ◽  
Multivariable Logistic Regression ◽  
Peristomal Skin ◽  
The Impact ◽  
Conut Score

AbstractWhile nutritional interventions may potentially lower the risk of peristomal skin disorders (PSDs) and their exacerbation, no previous studies have evaluated the relationship between PSDs and nutritional status using the Controlling Nutritional Status (CONUT) score. The purpose of this study was to assess the impact of preoperative nutritional status on stoma health, and determine risk factors for postoperative PSDs, including severe PSDs. A retrospective analysis was performed of 116 consecutive patients with rectal cancer who underwent radical surgery with ileostomy or colostomy creation. PSDs were diagnosed in 32 patients (27.6%); including 10 cases (8.7%) that were defined as severe based on the ABCD-stoma score. Multivariable logistic regression showed that smoking (odds ratio [OR] 3.451, 95% confidence interval [CI] 1.240–9.607, p = 0.018) and ileostomy (OR 3.287, 95% CI 1.278–8.458, p = 0.014) were independent risk factors for PSDs. A separate multivariable logistic regression analysis of risk factors for severe PSDs, found that the only independent risk factor was the CONUT score (OR 10.040, 95% CI 1.191–84.651, p = 0.034). Severe PSDs are associated with preoperative nutritional disorders, as determined by the CONUT score. Furthermore, nutritional disorders may increase the severity of PSDs, regardless of the stoma type.

scholarly journals Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients

2020 ◽  
Author(s):  
Marcin Zeman ◽  
Marek Czarnecki ◽  
Andrzej Chmielarz ◽  
Adam Idasiak ◽  
Maciej Grajek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Rectal Resection ◽  
Loop Ileostomy ◽  
Significant Risk ◽  
Plasma Fibrinogen ◽  
Fibrinogen Concentration ◽  
Permanent Stoma ◽  
Anterior Rectal Resection ◽  
The Impact

Abstract Background: One of the most severe complications of low anterior rectal resection is anastomotic leakage (AL). The creation of a loop ileostomy (LI) reduces the prevalence of AL requiring surgical intervention. However, up to one-third of temporary stomas may never be closed.The first aim of the study was to perform a retrospective assessment of the impact of LI on the risk of permanent stoma (PS) and symptomatic AL. The second aim of the study was to assess preoperative PS risk factors in patients with LI.Methods: A total of 286 consecutive patients who underwent low anterior rectal resection were subjected to retrospective analysis. In 101 (35.3%) patients, diverting LI was performed due to low anastomosis, while in the remaining 185 (64.7%) patients, no ileostomy was performed. LIs were reversed after adjuvant treatment. Analyses of the effect of LI on symptomatic AL and PS were performed. Among the potential risk factors for PS, clinical factors and the values ​​of selected peripheral blood parameters were analysed.Results: PS occurred in 37.6% and 21.1% of the patients with LI and without LI, respectively (p <0.01). Symptomatic ALs were significantly more common in patients without LI. In this group, symptomatic ALs occurred in 23.8% of patients, while in the LI group, they occurred in 5% of patients (p <0.001). In the LI group, the only significant risk factor for PS in the multivariate analysis was preoperative plasma fibrinogen concentration (OR = 1.007, 97.5% CI 1.002-1.013, p = 0.013).Conclusions: Although protective LI may reduce the incidence of symptomatic AL, it can be related to a higher risk of PS in this group of patients. The preoperative plasma fibrinogen concentration can be a risk factor for PS in LI patients and may be a useful variable in decision-making models.

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