To investigate the incidence and risk factors of incisional hernias after stoma closure.

A retrospective analysis was performed on patients undergoing ostomy reduction from July 2015 to December 2019 in the Department of General Surgery of Nanjing Drum Tower Hospital. Gender, age, body mass index (BMI), hypertension, diabetes, benign or malignant disease, ileostomy or colostomy, emergency or elective surgery, stoma (end type or loop type), ostomy was endoscopic or not, operation time, blood loss, postoperative hospital stay, postoperative incision infection, follow-up time, and whether incisional hernia occurred again at the original stoma were recorded. The risk factors for incisional hernia that occurred after stoma reduction were evaluated by univariate analysis and multivariate logistic regression analysis.

A total of 89 patients were analyzed. The incidence of ostomy site incisional hernias after stoma closure was 23.6% (21 cases), of which 9 underwent surgical treatment and the others received conservative treatment. Univariate analysis and multivariate logistic regression analysis suggested that the independent risk factors for incisional hernia included: colostomy (OR 7.161, 95% CI 1.479-34.667, P=0.014), age ≥68 years (OR 1.093, 95% CI 1.029-1.161, P=0.004), emergency surgery (OR 6.343, 95% CI 1.663-24.190, P=0.007). The BMI of patients with incisional hernia after stoma closure was higher than that of patients without incisional hernia [(25.2±3.5) kg/m² vs (23.2±2.8) kg/m²], and the difference was statistically significant (P=0.009).

Ostomy site incisional hernias after stoma closure often occurs, which often requires secondary surgical treatment, which seriously affects the quality of life of patients and increases the economic burden. Colostomy, age ≥68 years and emergency surgery are independent risk factors for incisional hernia. For these patients and patients with BMI≥25 kg/m², stoma closure combined with preventive mesh implantation can be used as clinical treatment.