Presentation (CTI)

OBJECTIVES: In Italy approximately 75,000 individuals live with a stoma, with over 18,000 new cases annually. While these procedures are often necessary to manage complex or advanced gastrointestinal diseases, they carry a considerable burden in terms of mid and long-term complications, most notably parastomal hernia. The aim of the study was to estimate the proportion of patients who are hospitalized for an abdominal hernia repair following a colostomy or ileostomy procedure in Italy.
METHODS: From Hospital Discharge Records, which collect information related to all discharges from public and private hospitals in Italy, all patients residing in Italy who had at least one hospital admission (HA) with a procedure of either colostomy or ileostomy (index event) in 2015 were identified. Each patient was followed for four years (follow-up) from the index event, to estimate the incidence of HA for abdominal hernia repair following aforementioned procedures. Results were stratified by index procedure (ileostomy, colostomy, ileostomy + colostomy), risk factors (diabetes, COPD, malnutrition, obesity) and underlying conditions (Crohn’s Disease, Ulcerative Colitis, Colorectal Cancer).
RESULTS: Patients enrolled were 13,176, the cumulative risk incidence of HA for abdominal hernia repair at 4 years of follow-up was 11.2%. Analysis shows a different percentage of patients treated for abdominal hernia repair with COPD (10.4%), diabetes (9.9%), or malnutrition (8.8%), while in obese patients a 4-year incidence rate of 18.4% was observed. With regard to clinical risk factors, patients with ulcerative colitis showed a risk of 12.5%, while those with Crohn's disease 11.9% and patients with colorectal cancer 8.9%.
CONCLUSIONS: Abdominal hernia represents a frequent complication in patients with intestinal stoma, particularly among those with obesity and inflammatory bowel diseases. These findings highlight the importance of targeted preventive strategies in high-risk populations.