Incidence, risk factors, and predictive modeling of stoma site incisional hernia after enterostomy closure: a multicenter retrospective cohort study

PurposeStoma site incisional hernia (SSIH) is a common complication, but its incidence and risk factors are not well known. The objective of this study is to explore the incidence and risk factors of SSIH and build a predictive model.MethodsWe performed a multicenter retrospective analysis on the patients who underwent enterostomy closure from January 2018 to August 2020. Patient's general condition, perioperative, intraoperative, and follow-up information was collected. The patients were divided into control group (no occurrence) and observation group (occurrence) according to whether SSIH occurred. Univariate and multivariate analysis were used to evaluate the risk factors of SSIH, following which we constructed a nomogram for SSIH prediction.ResultsOne hundred fifty-six patients were enrolled in the study. The incidence of SSIH was 24.4% (38 cases), of which 14 were treated with hernia mesh repair, and the others were treated with conservative treatment. Univariate and multivariate analysis showed that age >= 68 years (OR 1.045, 95% CI 1.002 similar to 1.089, P = 0.038), colostomy (OR 2.913, 95% CI 1.035 similar to 8.202, P = 0.043), BMI >= 25 kg/m(2) (OR 1.181, 95% CI 1.010 similar to 1.382, P = 0.037), malignant tumor (OR 4.838, 95% CI 1.508 similar to 15.517, P = 0.008) and emergency surgery (OR 5.327, 95% CI 1.996 similar to 14.434, P = 0.001) are the independent risk factors for SSIH.ConclusionsBased on the results, a predictive model for the occurrence of SSIH was constructed to screen high-risk groups of SSIH. For patients at high risk for SSIH, how to deal with the follow-up and prevent the occurrence of SSIH is worth further exploration.