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• W2098740056 abstract "No AccessJournal of UrologyAdult Urology1 May 2014Incidence and Risk Factors of Parastomal Hernia in Patients Undergoing Radical Cystectomy and Ileal Conduit Diversion Nick W. Liu, Jeromy T. Hackney, Paul T. Gellhaus, M. Francesca Monn, Timothy A. Masterson, Richard Bihrle, Thomas A. Gardner, Michael G. House, and Michael O. Koch Nick W. LiuNick W. Liu Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , Jeromy T. HackneyJeromy T. Hackney Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , Paul T. GellhausPaul T. Gellhaus Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , M. Francesca MonnM. Francesca Monn Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , Timothy A. MastersonTimothy A. Masterson Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , Richard BihrleRichard Bihrle Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , Thomas A. GardnerThomas A. Gardner Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Financial interest and/or other relationship with Dendreon. More articles by this author , Michael G. HouseMichael G. House Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author , and Michael O. KochMichael O. Koch Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Financial interest and/or other relationship with Myriad and Sonocare. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.11.104AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the incidence and risk factors of parastomal hernia formation in patients undergoing radical cystectomy and ileal conduit urinary diversion. Materials and Methods: We retrospectively reviewed the Indiana University cystectomy database between 2001 and 2011, and identified 516 patients who underwent radical cystectomy and ileal conduit diversion. Overall 199 patients had a clinical followup of at least 12 months and all underwent postoperative staging computerized tomography to confirm the presence of parastomal hernia. The incidence of parastomal hernia is reported with correlations made to demographic, patient level and perioperative risk factors. Results: A parastomal hernia developed in 58 patients (29%) at a median followup of 27 months (range 12 to 125). Of these patients 26 (45%) underwent surgical repair due to abdominal discomfort (58%), acute strangulation or obstruction of the small bowel (15%), partial small bowel obstructions (15%) and elective repair for other intra-abdominal procedures (12%). Prior exploratory laparotomy (adjusted HR 1.98, 95% CI 1.97–3.36, p = 0.011) and severe obesity (adjusted HR 4.26, 95% CI 1.52–11.93, p = 0.006) were predictive of parastomal herniation. The cumulative risk of parastomal hernia formation at 1 and 2 years after cystectomy was 12.2% and 22.5%, respectively. Conclusions: We demonstrated that parastomal hernia will develop in nearly a third of patients after radical cystectomy with ileal conduit diversion. Prior laparotomy and severe obesity are independent risk factors. Preoperative counseling and preventative measures regarding parastomal hernia formation should be emphasized, particularly in these at risk patients. References 1 : Surgical complications of urinary diversion. World J Urol2004; 22: 157. Google Scholar 2 : Stomal complications of ileal conduits are significantly higher when formed in women with intractable urinary incontinence. J Urol2004; 172: 2300. Link, Google Scholar 3 : Incidence and risk factors of stomal complications in patients undergoing cystectomy with ileal conduit urinary diversion for bladder cancer. J Urol2007; 178: 950. Link, Google Scholar 4 : Quality of life after cystectomy and urinary diversion: an evidence based analysis. J Urol2005; 174: 1729. Link, Google Scholar 5 : Simplified technique for parastomal hernia repair after radical cystectomy and ileal conduit creation. Urology2011; 77: 1491. Google Scholar 6 : The persistent challenge of parastomal herniation: a review of the literature and future developments. 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Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByHussein A, Ahmed Y, May P, Ali T, Ahmad B, Raheem S, Stone K, Hasasnah A, Rana O, Cole A, Wang D, Loud P and Guru K (2018) Natural History and Predictors of Parastomal Hernia after Robot-Assisted Radical Cystectomy and Ileal Conduit Urinary DiversionJournal of Urology, VOL. 199, NO. 3, (766-773), Online publication date: 1-Mar-2018.Hussein A, Hashmi Z, Dibaj S, Altartir T, Fiorica T, Wing J, Durrani M, Binkowski J, Boateng L, Wilding G and Guru K (2018) Reoperations following Robot-Assisted Radical Cystectomy: A Decade of ExperienceJournal of Urology, VOL. 195, NO. 5, (1368-1376), Online publication date: 1-May-2016.Movassaghi K, Shah S, Cai J, Miranda G, Fernandez J, Duddalwar V, Daneshmand S and Djaladat H (2018) Incisional and Parastomal Hernia following Radical Cystectomy and Urinary Diversion: The University of Southern California ExperienceJournal of Urology, VOL. 196, NO. 3, (777-781), Online publication date: 1-Sep-2016. Volume 191Issue 5May 2014Page: 1313-1318 Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordsherniaurinary diversioncystectomyurinary bladder neoplasmsabdominalMetricsAuthor Information Nick W. Liu Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author Jeromy T. Hackney Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author Paul T. Gellhaus Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author M. Francesca Monn Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author Timothy A. Masterson Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author Richard Bihrle Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author Thomas A. Gardner Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Financial interest and/or other relationship with Dendreon. More articles by this author Michael G. House Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana Nothing to disclose. More articles by this author Michael O. Koch Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana Financial interest and/or other relationship with Myriad and Sonocare. More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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