Dis Colon Rectum. 2022 Jan 31. doi: 10.1097/DCR.0000000000002395. Online ahead of print.
ABSTRACT
BACKGROUND: Parastomal hernias are common complications following ostomy surgery and affect the patient’s quality of life. We hypothesized that the patient’s physical activity (or lack thereof) might be associated with presence of parastomal hernia. If so, this might be an actionable target for prevention.
OBJECTIVE: The objective was to determine rates of and risk factors for parastomal hernias in patients who underwent surgery resulting in a permanent ostomy.
DESIGN: This was a retrospective cohort and survey study. Postal survey included questions about parastomal hernia, symptoms, lifestyle, and validated instruments to measure stoma quality of life and physical activity. Chart abstraction was conducted for clinical comorbidities.
SETTINGS: This study was conducted in single, large academic medical center.
PATIENTS: Patients who underwent operations that included a permanent urostomy, colostomy, and/or ileostomy between 2014 and 2018 were included in the study.
MAIN OUTCOME MEASURES: Parastomal hernia (self-reported) and physical activity, measured in total activity metabolic equivalent-minutes/week, were our main outcome measures. Quality of life was also assessed.
RESULTS: A total of 443 of 724 patients responded to the survey (response rate, 61.2%). 212 patients (47.9%) had urostomies, 160 (36.1%) had colostomies, and 99 (22.3%) had ileostomies. 128 patients (29.7%) had a parastomal hernia, with rates of 27.1% for urostomy, 40.0% for colostomy, and 23.7% for ileostomy. There was a statistically-significant association between less exercise and higher incidence of parastomal hernia (median, 579 metabolic equivalent -minutes/week for those with parastomal hernias v. 1689 for those without; p = 0.001).
LIMITATIONS: The association between physical activity and parastomal hernia may be confounded by obesity, or by the fact that parastomal hernia patients may have less physical activity due to their hernia.
CONCLUSIONS: Parastomal hernia rates remain high in modern surgical practice, and hernias are associated with poorer quality of life. This study shows an association between patients’ physical activity and the presence of a parastomal hernia, with a higher rate among patients who exercise less. See Video Abstract at http://links.lww.com/DCR/B910.
PMID:35714337 | DOI:10.1097/DCR.0000000000002395
