Risk Factors for Parastomal Hernia After Permanent Colostomy

SHI Jingrong; ZHU Xiaoxuan; MA Xu; HUANG Chenchen; AI Xu

doi:10.3639/j.issn.2095-3097.2025.08.018

Abstract：Objective This study aims to explore the risk factors for parastomal hernia after permanent colostomy following radical surgery for colorectal cancer.Methods A retrospective study was conducted on 316 patients with permanent colostomy admitted to the Department of Colorectal and Anal Surgery at Jingmen Central Hospital from January 2015 to February 2022.Baseline characteristics and follow-up information were obtained by collecting medical records.All patients underwent at least one abdominal CT scan after surgery to determine the presence of parastomal hernia.Univariate and multivariate Cox proportional hazards regression models were used to analyze the independent effects of patient baseline characteristics and intraoperative/postoperative parameters on parastomal hernia.Independent risk factors confirmed by the Cox model were incorporated to construct a nomogram for predicting parastomal hernia,and the predictive performance of the nomogram was evaluated.Results Among 316 patients,98 developed parastomal hernia.The cumulative incidence was 31.01%during a median follow-up of 28 months.The multivariate Cox model indicated that age,sex(female),body mass index,diabetes,and severe postoperative complications(Clavien-Dindo grades Ⅲ/Ⅳ)were independent risk factors for parastomal hernia(P<0.05).The nomogram incorporating these factors demonstrated areas under the receiver operating characteristic curve of 0.744,0.834,and 0.932 for predicting 1-year,2-year,and 3-year parastomal hernia occurrence,respectively.Conclusions Age,sex(female),body mass index,diabetes,and severe postoperative complications(grades Ⅲ/Ⅳ)are independent risk factors for parastomal hernia after permanent colostomy.Interventions targeting these factors may help prevent parastomal hernias.