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首页> 外文期刊>BJU international >Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit
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Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

机译：Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

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摘要

Objective: To investigate the incidence, risk factors and natural history of parastomal hernia (PSH). Materials and Methods: We reviewed the records of patients who underwent radical cystectomy (RC) and ileal conduit (IC) procedure between 2007 and 2020. Patients who had available follow-up computed tomography (CT) imaging were included in this study. All CT scans were re-reviewed for detection of PSH according to Moreno-Matias classification. Patients who developed hernia were followed up and classified into stable or progressive (defined as radiological upgrading and/or need for surgical intervention) groups. Multivariable Cox regression was performed to identify independent predictors of hernia development and progression. Results: A total of 361 patients were included in this study. The incidence of radiological PSH was 30, graded as I (56.5), II (12) and III (31.5). The median (interquartile range IQR) time to radiological hernia was 8 (5—15) months. During the median (IQR) follow-up of 27 (13-47) months in 108 patients with a hernia, 26 patients progressed. The median (IQR) time to progression was 12 (6-21) months. On multivariable analysis, female gender (hazard ratio HR 1.86), diabetes (HR 1.81), chronic obstructive pulmonary disease (COPD; HR 1.78) and higher body mass index (BMI; HR 1.07 for each unit) were independent predictors for radiological PSH development. No significant factor was found to be associated with hernia progression. Conclusion: Radiological PSH after RC and IC occurred in 30 of patients, a quarter of whom progressed in a median time of 12 months. Female gender, diabetes, COPD and high BMI were independent predictors for radiological hernia development.

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