Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Department of General Surgery, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
BMC Gastroenterol. 2023 Jun 10;23(1):201. doi: 10.1186/s12876-023-02805-4.
Stoma site incisional hernia (SSIH) is a common complication, but its incidence and risk factors are not well known. The objective of this study is to explore the incidence and risk factors of SSIH and build a predictive model.
We performed a multicenter retrospective analysis on the patients who underwent enterostomy closure from January 2018 to August 2020. Patient's general condition, perioperative, intraoperative, and follow-up information was collected. The patients were divided into control group (no occurrence) and observation group (occurrence) according to whether SSIH occurred. Univariate and multivariate analysis were used to evaluate the risk factors of SSIH, following which we constructed a nomogram for SSIH prediction.
One hundred fifty-six patients were enrolled in the study. The incidence of SSIH was 24.4% (38 cases), of which 14 were treated with hernia mesh repair, and the others were treated with conservative treatment. Univariate and multivariate analysis showed that age ≥ 68 years (OR 1.045, 95% CI 1.002 ~ 1.089, P = 0.038), colostomy (OR 2.913, 95% CI 1.035 ~ 8.202, P = 0.043), BMI ≥ 25 kg/m2 (OR 1.181, 95% CI 1.010 ~ 1.382, P = 0.037), malignant tumor (OR 4.838, 95% CI 1.508 ~ 15.517, P = 0.008) and emergency surgery (OR 5.327, 95% CI 1.996 ~ 14.434, P = 0.001) are the independent risk factors for SSIH.
Based on the results, a predictive model for the occurrence of SSIH was constructed to screen high-risk groups of SSIH. For patients at high risk for SSIH, how to deal with the follow-up and prevent the occurrence of SSIH is worth further exploration.
肠造口切口疝（SSIH）是一种常见的并发症，但其发病率和危险因素尚不清楚。本研究旨在探讨 SSIH 的发病率和危险因素，并建立预测模型。
我们对 2018 年 1 月至 2020 年 8 月期间进行肠造口关闭的患者进行了多中心回顾性分析。收集患者的一般情况、围手术期、术中及随访信息。根据是否发生 SSIH 将患者分为对照组（无发生）和观察组（发生）。采用单因素和多因素分析评估 SSIH 的危险因素，随后构建 SSIH 预测的列线图。
本研究共纳入 156 例患者。SSIH 的发生率为 24.4%（38 例），其中 14 例采用疝修补网片治疗，其余采用保守治疗。单因素和多因素分析表明，年龄≥68 岁（OR 1.045，95%CI 1.0021.089，P=0.038）、结肠造口术（OR 2.913，95%CI 1.0358.202，P=0.043）、BMI≥25kg/m2（OR 1.181，95%CI 1.0101.382，P=0.037）、恶性肿瘤（OR 4.838，95%CI 1.50815.517，P=0.008）和急诊手术（OR 5.327，95%CI 1.996~14.434，P=0.001）是 SSIH 的独立危险因素。
基于这些结果，构建了一个预测 SSIH 发生的模型，以筛选 SSIH 的高危人群。对于 SSIH 高危患者，如何处理随访并预防 SSIH 的发生值得进一步探讨。
