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Purpose <p>Stoma-site incisional hernia is a concerning complication following ileostomy closure. We conducted this study to investigate the effectiveness of a three-layer closure technique for preventing stoma-site incisional hernia after ileostomy closure in patients with rectal cancer.</p> Methods <p>This single-center pre–post comparative study included 169 patients who underwent diverting loop ileostomy closure after rectal cancer surgery between April 2016 and May 2025. The three-layer closure technique replaced the single-layer technique in July 2020, and the outcomes before and after this change were compared. Firth-corrected multivariate analysis was performed to identify independent risk factors for stoma-site incisional hernia.</p> Results <p>Stoma-site incisional hernias developed in 12 patients (7.1%). The incidence of stoma-site incisional hernia was significantly lower in the three-layer closure group than in the single-layer closure group (1.1% vs. 13%, <i>P</i> = 0.002). The Firth-corrected multivariate analysis identified that the three-layer closure technique (odds ratio 0.12, 95% confidence interval 0.01–0.55, <i>P</i> = 0.004) was an independent protective factor.</p> Conclusions <p>The three-layer closure technique reduced stoma-site incisional hernia significantly after ileostomy closure in patients with rectal cancer, suggesting that anatomically layered reconstruction provides superior abdominal wall integrity to single-layer closure.</p>

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Effectiveness of a three-layer closure technique for preventing stoma-site incisional hernia after stoma closure in patients with rectal cancer

  • 期刊论文

  • 发表日期：

    2026年5月21日

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  • Yasuhiro Takano,
  • Yasuhiro Takeda,
  • Keisuke Goto,
  • Teppei Kamada,
  • Shu Tsukihara,
  • Yasunobu Kobayashi,
  • Yuta Imaizumi,
  • Shunjin Ryu,
  • Masahisa Ohkuma,
  • Makoto Kosuge,
  • Ken Eto

摘要

Purpose

Stoma-site incisional hernia is a concerning complication following ileostomy closure. We conducted this study to investigate the effectiveness of a three-layer closure technique for preventing stoma-site incisional hernia after ileostomy closure in patients with rectal cancer.

Methods

This single-center pre–post comparative study included 169 patients who underwent diverting loop ileostomy closure after rectal cancer surgery between April 2016 and May 2025. The three-layer closure technique replaced the single-layer technique in July 2020, and the outcomes before and after this change were compared. Firth-corrected multivariate analysis was performed to identify independent risk factors for stoma-site incisional hernia.

Results

Stoma-site incisional hernias developed in 12 patients (7.1%). The incidence of stoma-site incisional hernia was significantly lower in the three-layer closure group than in the single-layer closure group (1.1% vs. 13%, P = 0.002). The Firth-corrected multivariate analysis identified that the three-layer closure technique (odds ratio 0.12, 95% confidence interval 0.01–0.55, P = 0.004) was an independent protective factor.

Conclusions

The three-layer closure technique reduced stoma-site incisional hernia significantly after ileostomy closure in patients with rectal cancer, suggesting that anatomically layered reconstruction provides superior abdominal wall integrity to single-layer closure.