Pu Yu Wei, Yang Xiao Dong, Gong Wei, Xing Chun Gen
Department of General Surgery, The Second Affiliated Hospital, Soochow University, Suzhou, China.
Wideochir Inne Tech Maloinwazyjne. 2019 Sep;14(3):387-393. doi: 10.5114/wiitm.2019.81409. Epub 2019 Jan 21.
Parastomal hernia is a common complication after stoma formation. The definitive risk factors for parastomal hernia development remain unclear.
This study evaluated the risk factors through computed tomography (CT) scan of patients with parastomal hernia.
All patients who underwent an operation at our institution from January 2008 to February 2014 were included. We recorded patient-related and operation-related variables, and CT scans were checked. All the variables were analyzed with SPSS 19 to identify the risk factors for parastomal hernia formation.
Of the 128 patients who underwent colostomy, 49 (38.3%) developed a parastomal hernia during a median follow-up period of 20.1 months (range: 4-84 months). Hernia development was significantly associated with the thickness of subcutaneous fat in the abdominal wall, the location of the stoma, anteroposterior diameter and horizontal diameter of the body. The defect size of the abdominal wall is another risk factor. The larger the defect size of the abdominal wall, the larger is the parastomal stoma (3.79 ±1.51 vs. 2.13 ±0.74 cm horizontally and 4.90 ±2.25 vs. 2.94 ±0.73 cm vertically, p < 0.001). The hernia contents protrude into the hernial sac through the path of the inner side more than the outer side (77.6% vs. 12.2%).
Our findings in Chinese patients with parastomal hernia match those from Western countries: obesity, the location of the stoma, and the defect size of the abdominal wall are significant risk factors for parastomal hernia formation. The mesenteric region is a weak area, which is a site prone to parastomal hernia, and should be protected.
造口旁疝是造口形成后的常见并发症。造口旁疝发生的确切危险因素尚不清楚。
本研究通过对造口旁疝患者进行计算机断层扫描（CT）来评估危险因素。
纳入2008年1月至2014年2月在我院接受手术的所有患者。记录患者相关和手术相关变量，并检查CT扫描结果。使用SPSS 19对所有变量进行分析，以确定造口旁疝形成的危险因素。
在128例行结肠造口术的患者中，49例（38.3%）在中位随访期20.1个月（范围：4 - 84个月）内发生了造口旁疝。疝的发生与腹壁皮下脂肪厚度、造口位置、身体前后径和横径显著相关。腹壁缺损大小是另一个危险因素。腹壁缺损越大，造口旁疝口越大（水平方向分别为3.79±1.51 vs. 2.13±0.74 cm，垂直方向分别为4.90±2.25 vs. 2.94±0.73 cm，p < 0.001）。疝内容物通过内侧路径突入疝囊的比例高于外侧（77.6% vs. 12.2%）。
我们在中国造口旁疝患者中的研究结果与西方国家的结果相符：肥胖、造口位置和腹壁缺损大小是造口旁疝形成的重要危险因素。肠系膜区域是一个薄弱区域，是易发生造口旁疝的部位，应予以保护。
