To explore the incidence, risk factors of parastomal hernia after enterostomy, and to construct a prediction model.

Selected 155 patients who underwent enterostomies at the General Surgery Department of Nanjing Drum Tower Hospital from July 2015 to December 2020, collected patient data, and conducted retrospective analysis. Patients were divided into a control group (no parastomal hernia) and a parastomal hernia group (parastomal hernia) according to the occurrence of postoperative parastomal hernia. Univariate analysis was conducted on patient’s gender, age, body mass index (BMI), hypertension, diabetes, colostomy parts (ileum and colon), timing of surgery (emergency or elective), type of disease (benign or malignant), colostomy method (end or loops), colostomy location (extraperitoneal or intraperitoneal), operation time, blood loss, postoperative hospital stay, postoperative incision infection, and follow-up time. Multivariate logistic regression analysis were used to evaluate the risk factors for parastomal hernia after enterostomy, and a prediction model was established.

A total of 155 patients underwent enterostomy, and the incidence of parastomal hernia was 12.9% (20/155). Among them, 7 patients underwent secondary surgery and 13 underwent conservative treatment. Univariate analysis showed that age, BMI, stoma site (ileum or colon), disease type (benign or malignant), stoma location (extraperitoneal or intraperitoneal), and postoperative wound infection were the influencing factors for the occurrence of postoperative stomal hernia. However, gender, hypertension, diabetes, chronic obstructive pulmonary diseases, timing of surgery (emergency or elective), stoma method (end or loop), operation time, blood loss, postoperative hospital stay, and follow-up time did not affect the occurrence of peristomal hernia. Further multivariate logistic regression analysis showed that age ≥70 years (OR 1.079, 95% CI 1.006~1.157, P=0.035), BMI ≥26.3 kg/m² (OR 1.190, 95% CI 1.021~1.388, P=0.026), colostomy (OR 4.629, 95% CI 1.132~18.926, P=0.033) and postoperative wound infection (OR 3.303, 95% CI 1.009~10.821, P=0.048) were independent risk factors for parastomal hernia after enterostomy.

For patients with an age ≥70 years old, BMI ≥26.3 kg/m², and colostomies attention should be paid to a fine operation to prevent incision infection. Enterostomy combined with prophylactic mesh placement can be considered to reduce the incidence of parastomal hernia.