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The rate of ileostomy site incisional hernias: more common than we think?

Purpose Incisional hernias (IH) rates after diverting loop ileostomy reversal (DLI-R) have been reported up to 24%. We aimed to characterize the incidence rate and risk factors associated with DLI-R site IH formation within 1-year in a large patient cohort. Methods A retrospective review at a single...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2024-12, Vol.28 (6), p.2311-2320
Main Authors: Obi, Megan, Beffa, Lucas, Melland-Smith, Megan, Messer, Nir, Kanters, Arielle, Judeeba, Sami, Baier, Kevin, Miller, Benjamin, Krpata, David, Prabhu, Ajita, Steele, Scott R., Rosen, Michael, Holubar, Stefan D., Petro, Clayton
Format: Article
Language:English
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Summary:Purpose Incisional hernias (IH) rates after diverting loop ileostomy reversal (DLI-R) have been reported up to 24%. We aimed to characterize the incidence rate and risk factors associated with DLI-R site IH formation within 1-year in a large patient cohort. Methods A retrospective review at a single quaternary referral center hospital of adult patients who underwent DLI-R over a 5-year period and abdominal computerized tomography (CT) imaging performed within 1-year for any indication postoperatively was conducted. All CTs scans were independently reviewed by staff surgeons to determine the presence of a fascial defect at the DLI-R site. Results 2,196 patients underwent DLI-R; of these, 569 (25.9%) underwent CT imaging for any indication. Mean patient age, 54.8 (± 14.9), BMI 27.6 kg/m 2 . 87 (15%) patients had a parastomal hernia at time of DLI-R. After median follow-up of 10 months, 203 patients (35.7%) had IH at the DLI-R site. Age ( p  = 0.14), sex ( p  = 0.39), race ( p  = 0.75), and smoking status ( p  = 0.82) weren’t associated with IH after DLI-R. Comorbidities weren’t significantly associated with IH following DLI-R. In univariate analysis, increased BMI ( p  
ISSN:1248-9204
1265-4906
1248-9204
DOI:10.1007/s10029-024-03163-0