Show simple item record

dc.contributor.authorHo, K
dc.contributor.authorEconomou, T
dc.contributor.authorSmart, N
dc.contributor.authorDaniels, I
dc.date.accessioned2018-10-25T10:17:57Z
dc.date.issued2018-10-24
dc.description.abstractBackground Development of a parastomal hernia is common following abdominoperineal excision (APE). The true incidence is difficult to assess fully owing to differing lengths of follow‐up and techniques used to assess herniation; radiological or clinical. The primary aim of this study was to evaluate colostomy diameter by studying the rate of change of axial and sagittal trephine diameters, trephine area, and the ratio of the trephine over time. A secondary aim was to investigate variation in trephine area and variables affecting parasternal hernia over time. Methods Serial CT scans performed after APE from January 2006 to December 2014 were reviewed. Variables analysed included age, sex, trephine position relative to rectus abdominis muscle (RAM), type of incision for stoma creation, and axial and sagittal trephine diameters measured on follow‐up CT. A Bayesian hierarchical modelling framework was used to examine the relationship of trephine diameters, area and ratio over time. Results Of 112 patients undergoing APE, 103 were eligible for analysis; this included 91 colostomies (88·3 per cent) through the RAM and 12 (11·7 per cent) lateral to the RAM. Median age of the patients was 68 years. Sixty patients (58·3 per cent) had a circular and 43 (41·7 per cent) a cruciate incision for stoma creation. The sagittal trephine diameter increased by 0·22 (95 per cent credible interval 0·12 to 0·32) mm/month for both sexes. Women reported a significant increase in axial trephine diameters; the male : female ratio difference was −0·17 (−0·30 to −0·03) mm/month and for trephine areas −6·21 (0·96 to 13·7) mm2/month. Patient age, colostomy trephine location and shape of incision were not statistically significant variables for parasternal hernia. Conclusion Female sex was the only variable affecting the rate of increase in axial trephine diameter and trephine area over time.en_GB
dc.identifier.citationPublished online 24 October 2018en_GB
dc.identifier.doi10.1002/bjs5.50109
dc.identifier.urihttp://hdl.handle.net/10871/34442
dc.language.isoenen_GB
dc.publisherWileyen_GB
dc.rights© 2018 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.en_GB
dc.titleRadiological progression of end colostomy trephine diameter and areaen_GB
dc.typeArticleen_GB
dc.date.available2018-10-25T10:17:57Z
dc.descriptionThis is the final version. Available from Wiley via the DOI in this recorden_GB
dc.descriptionPresented as a poster to a meeting of the Digestive Disorders Federation, London, UK, June 2015, and the 11th Scientific Meeting of the European Society of Coloproctology, Milan, Italy, September 2016en_GB
dc.identifier.journalBJS Openen_GB


Files in this item

This item appears in the following Collection(s)

Show simple item record