Original Articles
Clinical and radiological assessment of incisional hernias following closure of temporary stomas | |
Dr. Neha, Dr. Abhinav Kumar | |
Background: Incisional hernias are a frequently observed complication following abdominal surgeries, with incidence rates reported between 2% and 11% among patients undergoing these interventions. Hence; the present study was conducted for assessing clinical and radiological assessment of incisional hernias following closure of temporary stomas. Materials & methods: A cohort of 100 patients who had undergone either ileostomy or colostomy closure was included in this study. The inclusion criteria specified that participants must have had a reversal of any type of ileostomy or colostomy and must have undergone either computed tomography (CT) or magnetic resonance imaging (MRI) at least three months post-stoma reversal. A radiologist was specifically trained to detect abdominal wall and incisional hernias using the imaging techniques employed in this study (CT or MRI), following a standardized proforma. A radiological hernia was defined by the presence of: (1) a discontinuity in the transverse abdominal fascia; (2) the visualization of fat, peritoneum, or bowel breaching a surgical incision site, either in the right or left iliac fossae for stoma site hernias or along the midline for midline incisional hernias. All findings were documented in a Microsoft Excel spreadsheet and subsequently analyzed statistically using SPSS software. Univariate analysis was done for evaluation of level of significance. Results: A total of 100 patients were evaluated. Among these 100 patients, 40 patients were with hernia at site of stoma reversal, while remaining 60 patients were without hernia. Among patients with hernia, there were 32 males and 8 females. Among patients without hernia, males and females were 50 and 10.Clinical follow-up, radiographic imaging and combined methods showed rate of incisional hernia a at site of stoma reversal to be 15 percent, 33 percent and 39 percent respectively. Conclusion: The occurrence of hernias at the sites of stoma closure may be more prevalent than previously thought. Advanced imaging techniques, such as computed tomography (CT) scans, could serve as an early indicator for the development of clinically significant hernias at a later stage |
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