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Risk of mortality and recurrence after parastomal hernia repair

The latest issue of the Diseases of the Colon & Rectum evalautes the risk of mortality and recurrence after parastomal hernia repair.

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Surgical outcome results after repair for parastomal hernia are sparsely reported, and based on small-scale studies.

Dr Frederik Helgstrand and colleagues analyzed surgical risk factors for 30-day reoperation and mortality, and, secondarily, to report the risk of reoperation for recurrence.

The team performed a retrospective analysis of nationwide perioperative surgical variables.

The primary outcome was reoperation for surgical complications and/or mortality within 30 days after parastomal hernia repair.

Follow-up was obtained from the Danish National Patient Register.

Detailed patient-related data were based on hospital files.

13% were reoperated because of postoperative complications
Diseases of the Colon & Rectum

Multivariate analysis was based on a compound parameter of 30-day reoperation or death.

The team evaluated all patients with a parastomal hernia repair registered in the Danish Hernia Database from 2007 to 2010.

The team used univariate and logistic regression to identify risk factors for 30-day reoperation or death.

The researchers included 174 patients with a parastomal hernia repair.

Median follow-up was 20 months.

A total of 13% were reoperated because of postoperative complications, and 6% of patients died within the first 30 postoperative days.

The research team observed that emergency repair was the strongest risk factor for reoperation or death in multivariate analyses.

No difference was found in preoperative risk of poor outcome between elective and emergency repairs.

The team noted that after 3 years, the cumulated reoperation rate for recurrence was 11%.

Dr Helgstrand's team concludes, "In the present nationwide study, repair for a parastomal hernia was associated with high rates of morbidity, mortality, and repair for recurrence."

"Emergency repair was the only important risk factor to predict poor 30-day postoperative outcome."

Dis Colon Rectum 2013: 56(11): 1265–1272
15 November 2013

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