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