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Ostomy function after abdominoperineal resection—a clinical and patient evaluation

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Abdominoperineal resection (APR) for rectal cancer results in a permanent colostomy. As a consequence of a recent change in operative technique from standard (S-APR) to extralevator resection (E-APR), the perineal part of the procedure is now performed with the patient in a prone jackknife position. The impact of this change on stoma function is unknown. The aim was to determine stoma-related complications and the individual patient experience of a stoma.

Methods

Consecutive patients with rectal cancer operated on with APR in one institution in 2004 to 2009 were included. Recurrent cancer, palliative procedures, pre-existing stoma and patients not alive at the start of the study were excluded. Data were collected from hospital records and the national colorectal cancer registry. A questionnaire was sent out to patients. The median follow-up was 44 months (13–84) after primary surgery.

Results

Ninety-six patients were alive in February 2011. Seventy seven agreed to participate. Sixty-nine patients (90 %) returned the questionnaire. Stoma necrosis was more common for E-APR, 34 % vs. 10 %, but bandaging problems and low stoma height were more common for S-APR. There were no differences in the patients' experience of stoma function. In all, 35 % of the patients felt dirty and unclean, but 90 % felt that they had a full life and could engage in leisure activities of their choice.

Conclusions

This exploratory study indicates no difference in stoma function after 1 year between S-APR and E-APR. Over 90 % of the patients accept their stoma, but our study indicates that more information and support for patients are warranted.

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Funding

This study received funding from the Assar Gabrielsson Foundation, the Swedish Society of Medicine, the Gothenburg Medical Society and the Swedish Cancer Foundation, Sahlgrenska University Hospital (ALF).

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None of the authors have any conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital/Östra campus, 416 85, Gothenburg, Sweden

    E. Angenete, A. Correa-Marinez, J. Heath, E. González, A. Wedin, D. Asplund & E. Haglind

  2. SSORG–Scandinavian Surgical Outcomes Research Group, Gothenburg, Sweden

    E. Angenete, A. Correa-Marinez, J. Heath, E. González, A. Wedin, M. Prytz, D. Asplund & E. Haglind

  3. Norra Älvsborgs Länssjukhus, Trollhättan, Sweden

    M. Prytz

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  1. E. Angenete
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Correspondence to E. Angenete.

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Angenete, E., Correa-Marinez, A., Heath, J. et al. Ostomy function after abdominoperineal resection—a clinical and patient evaluation. Int J Colorectal Dis 27, 1267–1274 (2012). https://doi.org/10.1007/s00384-012-1463-1

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