{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:06:31Z","timestamp":1790251591367,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine our incidence of parastomal hernia (PSH) after end colostomy formation and to integrate clinical and novel computed tomography (CT)\u2010derived stoma\u2010site risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective study of adults undergoing operations resulting in permanent end colostomy at Dunedin Hospital, New Zealand (2009\u20132022), who had at least one pre\u2010 or post\u2010operative abdominal CT scan. PSH and risk factors were identified clinically from electronic medical records or radiologically using the Moreno\u2010Matias classification. Radiological variables included abdominal wall width, rectus muscle\u2010to\u2010subcutaneous fat ratio, rectus density, intraperitoneal area, aperture size and stoma location within the rectus muscle; univariable and multivariable logistic regression identified independent predictors of PSH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 217 patients, 64 (29%) were diagnosed with PSH, with approximately half symptomatic. Univariable analysis identified six risk factors: body mass index, diabetes, abdominal wall width, abdominal wall muscle\u2010to\u2010fat ratio, fascial defect diameter and stoma position within the rectus. In adjusted analyses, larger defect diameter (OR: 3.24 per 1\u2009cm increase, 95% CI; 1.96\u20135.91), abdominal wall muscle\u2010to\u2010fat ratio (OR: 0.68 per 10% increase, 95% CI: 0.49\u20130.88) and lateral stoma position (OR: 2.79, 95% CI: 1.03\u20137.86) were independently associated with PSH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combining clinical information with CT\u2010based morphological assessment identified aperture size and abdominal wall muscle\u2010to\u2010fat ratio as key risk factors, and precise central transrectus stoma placement as a risk factor of interest. These findings may inform preoperative risk stratification, technical optimisation of stoma construction and selection of patients for prophylactic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70795","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:37:18Z","timestamp":1781523438000},"page":"2593-2599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integration of Clinical Risk Factors With Radiological Metrics Associated With\n                    <scp>PSH<\/scp>\n                    : The Impact of Stoma Site Features, Obesity and Muscle Atrophy"],"prefix":"10.1111","volume":"96","author":[{"given":"Moea","family":"Nimmo","sequence":"first","affiliation":[{"name":"Te Whatu Ora\/Health New Zealand Southern  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4908-7413","authenticated-orcid":false,"given":"Kari A.","family":"Clifford","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care, Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Woodfield","sequence":"additional","affiliation":[{"name":"Te Whatu Ora\/Health New Zealand Southern  Dunedin New Zealand"},{"name":"Department of Surgery and Critical Care, Dunedin School of Medicine University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","first-page":"1","article-title":"European Hernia Society Classification of Parastomal Hernias","volume":"18","author":"Szczepkowski M.","year":"2014","journal-title":"Hernia"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.70071"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4220"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01564.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.19.22498"},{"key":"e_1_2_9_7_1","volume-title":"Surgery of Anus, Colon and Rectum","author":"Goligher J.","year":"1984"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2015.11.020"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13771"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-016-1367-6"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2011.10.006"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.17151"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2003.00403.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9366-5"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2001.00256.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-019-03292-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-021-04068-5"},{"key":"e_1_2_9_18_1","first-page":"372","article-title":"Clinical Analysis on Risk Factors of the Colostomy Hernia After Rectal Cancer Miles Operations","volume":"45","author":"Zhu D. 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