{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T20:21:08Z","timestamp":1784751668045,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["14\/166\/01"],"award-info":[{"award-number":["14\/166\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009745","name":"Royal Devon and Exeter NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009745","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Abdominal surgery sometimes necessitates the creation of a stoma, which can cause future complications including parastomal hernia (PSH), an incisional hernia adjacent to and related to the stoma. PSH affects approximately 40% of patients within 2\u00a0years of stoma formation. Complications of PSH reduce a patient\u2019s quality of life and can be severe (e.g. bowel obstruction). PSHs are difficult to manage and can recur after surgical repair. Therefore, it is very important to prevent a PSH. Surgeons create stomas in different ways and both patient and surgical factors are believed to influence the development of PSH. The aim of the CIPHER study is to investigate the influence of different surgical techniques on the development of PSH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The UK cohort study to investigate the prevention of parastomal hernia (the CIPHER study) aims to recruit 4000 patients undergoing elective or expedited surgery with the intention of forming an ileostomy or colostomy, irrespective of the primary indication for the planned surgery. For each patient, surgeons will describe their methods of trephine formation, mesh reinforcement of the stoma trephine, use of the stoma as a specimen extraction site and wound closure. The primary outcome will be incident PSH during follow\u2010up, defined as symptoms of PSH (custom\u2010designed questionnaire) and anatomical PSH, ascertained by independent reading of usual care CT scans. Secondary outcomes will include surgical site infection, the Comprehensive Complication Index, quality of life (EQ\u20105D\u20105L and SF\u201012), PSH repair and use of NHS resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results of the study will be submitted for publication in peer\u2010reviewed journals. All publications relating to the results of CIPHER will use a corporate authorship, \u2018The CIPHER Study Investigators\u2019 with named writing committee members.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The CIPHER study will be the first to investigate detailed surgical methods of stoma formation in a large, representative cohort of patients with a range of primary indications, both cancer and noncancer.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15621","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T08:34:55Z","timestamp":1615278895000},"page":"1900-1908","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Protocol for the UK cohort study to investigate the prevention of parastomal hernia (the CIPHER study)"],"prefix":"10.1111","volume":"23","author":[{"given":"Hana","family":"Tabusa","sequence":"first","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane M.","family":"Blazeby","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Blencowe","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Callaway","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian R.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Royal Devon and Exeter NHS Foundation Trust Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Gunning","sequence":"additional","affiliation":[{"name":"Royal Devon and Exeter NHS Foundation Trust Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hollingworth","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augus G.","family":"McNair","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Murkin","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Pinkney","sequence":"additional","affiliation":[{"name":"University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris A.","family":"Rogers","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-8324","authenticated-orcid":false,"given":"Neil J.","family":"Smart","sequence":"additional","affiliation":[{"name":"Royal Devon and Exeter NHS Foundation Trust Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5101-9487","authenticated-orcid":false,"given":"Barnaby C.","family":"Reeves","sequence":"additional","affiliation":[{"name":"University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"issue":"8","key":"e_1_2_6_2_1","first-page":"352","article-title":"Stoma care nursing management: cost implications in community care","volume":"14","author":"Black P","year":"2013","journal-title":"Br J Community Nurs"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-013-1162-z"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2011.10.006"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236209"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.01.054"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12790"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181a0b358"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12585"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-012-0952-z"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181bdee8c"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14249"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10029-017-1697-5"},{"key":"e_1_2_6_14_1","unstructured":"Healthcare Quality Improvement Partnership (HQIP).National Bowel Cancer Audit. 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