International Journal of Colorectal Disease - A systematic review of the association between parastomal hernia and sarcopenia

Q: How do parastomal hernias relate to stoma-forming surgery?

Parastomal hernias can occur after surgeries requiring stoma formation and may lead to a second surgery or emergency surgical intervention.

Q: What did the systematic review conclude about the link between sarcopenia and hernia development?

No definitive relationship was found overall, but four included studies reported a significant relationship between sarcopenia and hernia formation.

Oct 3, 2026

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Background Sarcopenia is a multifactorial loss of muscle mass that can worsen surgical outcomes and raise morbidity and mortality. Parastomal hernias develop after operations requiring stoma formation and may necessitate a second surgery or emergency intervention. Aim Assess whether sarcopenia influences parastomal hernia formation in the postoperative period. Method MEDLINE, CINAHL, and Cochrane databases were searched and quality appraised with CCAT.

LanguageEnglish

CategoryResearch & Report

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Aim

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International Journal of Colorectal Disease (2023) 38:29 [https://doi.org/10.1007/s00384-023-04329-5](https://doi.org/10.1007/s00384-023-04329-5) A systematic review of the association between parastomal hernia and sarcopenia Grant Schutte1 · Declan Patton2,3,4,5,6 · Zena Moore2,3,4,5,7,8,9,10,11 · Deborah McNamara12,13 · Tom O’Connor2,3,4,5,9 · Linda Nugent3,4 · Pinar Avsar2,3 Accepted: 28 January 2023 © The Author(s) 2023 Abstract Background Sarcopenia is a multifactorial loss of muscle mass that can complicate surgical outcomes and increase morbidity and mortality. Parastomal hernias can occur after any surgery requiring stoma formation and is an area of concern as a complication as it can require a second surgery or emergency surgical intervention. Aim To assess the impact of sarcopenia on parastomal hernia formation in the postoperative period. Method A systematic search of publications using MEDLINE, CINAHL, and Cochrane databases was conducted in June 2022. Data were extracted, and a narrative synthesis was undertaken. The Crowe Critical Appraisal Tool (CCAT) assessed the quality of the included studies. The systematic review included original research studies, prospective and retrospective designs, and human studies written in English. Reviews, conference papers, opinion papers, and those including participants < 18 years old were excluded. No restrictions on the date of publication and study setting were applied. Results Nine studies met the inclusion criteria, and these were conducted between 2016 and 2021; 56%(n = 5) used a retrospective study design. The mean sample size was 242.5 participants (SD = ±358.6) . No consistent or standardized way of defining sarcopenia or measuring muscle mass was seen between the studies reviewed. However, 45%(n = 4) of the studies reported a significant relationship between sarcopenia and wound healing complications, including an increased incidence of parastomal and incisional hernias. The average CCAT score was 27.56 (SD = ±4.39) . Conclusion There is no definitive relationship between sarcopenia and hernia development; however, four studies found a significant relationship between sarcopenia and hernia formation. It must also be considered that different disease processes can cause sarcopenia either through the disease process itself, or the treatment and management. More research and consistent measurements are needed before comparable and consistent outcomes can be compiled. Keywords Sarcopenia · Parastomal hernia · Hernia Introduction Sarcopenia is when an individual’s muscle mass decreases compared to others of the same age, race, and gender [1] . It is a multifactorial process that can result from chronic illness, cancer, lack of activity, or a combination of these and many more factors [2–5] . Sarcopenia is not solely a disease of the old and frail but is seen in patients with increased BMIs and is independent of age [1, 3, 4] . This loss of muscle mass not only has an impact on activities of daily life but is a known risk factor for postoperative morbidity and * Pinar Avsar [pinaravsar@rcsi.com](pinaravsar@rcsi.com) Extended author information available on the last page of the article mortality in both the immediate and long-term postoperative periods [2–4, 6–10]. Many theories, such as chronically increased inflammatory processes, or a state of increased long-term catabolism, have been posited as reasons for the worsened postoperative outcomes, but no definitive etiology has been found [3, 6, 10] . The postoperative complications from sarcopenia are commonly but not limited to reduced survival, increased length of stay, higher rates of sepsis, a need for reoperations, increased need for rehabilitation, impaired physical capability, and decreased ability to cope with stressors, all of which increase cost and demand on the health care system [2, 3, 6, 8, 10, 11] . A parastomal hernia (PSH) occurs when a portion of the abdominal organs protru

FAQs

What is sarcopenia and why is it important for surgery?

Sarcopenia is a multifactorial loss of muscle mass that can complicate surgical outcomes and increase morbidity and mortality.

How do parastomal hernias relate to stoma-forming surgery?

Parastomal hernias can occur after surgeries requiring stoma formation and may lead to a second surgery or emergency surgical intervention.

What did the systematic review conclude about the link between sarcopenia and hernia development?

No definitive relationship was found overall, but four included studies reported a significant relationship between sarcopenia and hernia formation.

Oct 3, 2026

Upload by CatatanPagi