Ostomy function after abdominoperineal resection--a clinical and patient evaluation
E Angenete1, A Correa-Marinez, J Heath
1Department of Surgery, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital/Östra campus, Gothenburg, Sweden. eva.angenete@vgregion.se
International Journal of Colorectal Disease
|March 28, 2012
Summary
Extralevator resection (E-APR) for rectal cancer does not impact stoma function compared to standard APR. While stoma necrosis is higher with E-APR, patient acceptance and quality of life remain high.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Patient Outcomes
Background:
- Abdominoperineal resection (APR) for rectal cancer necessitates a permanent colostomy.
- A shift in surgical technique to extralevator resection (E-APR) from standard APR (S-APR) has occurred.
- The effect of E-APR on stoma function is not well-documented.
Purpose of the Study:
- To evaluate stoma-related complications after APR for rectal cancer.
- To assess the patient experience with a stoma following S-APR versus E-APR.
Main Methods:
- A cohort of rectal cancer patients undergoing APR between 2004-2009 was analyzed.
- Data were gathered from hospital records and a national registry.
- A patient questionnaire assessed stoma function and experience, with a median follow-up of 44 months.
Main Results:
- Stoma necrosis was more frequent in E-APR (34%) compared to S-APR (10%).
- Bandaging issues and low stoma height were more prevalent with S-APR.
- No significant differences in patient-reported stoma function were observed between the two techniques.
Conclusions:
- This study suggests E-APR does not negatively impact stoma function one year post-surgery compared to S-APR.
- Over 90% of patients achieve a good quality of life and accept their stoma.
- Increased patient information and support are recommended for those undergoing APR.
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