International Journal of Colorectal Disease

, Volume 27, Issue 10, pp 1267–1274

Ostomy function after abdominoperineal resection—a clinical and patient evaluation

  • E. Angenete
  • A. Correa-Marinez
  • J. Heath
  • E. González
  • A. Wedin
  • M. Prytz
  • D. Asplund
  • E. Haglind
Original Article

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.

Keywords

Ostomy Rectal cancer Abdominoperineal excision Quality of life 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • E. Angenete
    • 1
    • 2
  • A. Correa-Marinez
    • 1
    • 2
  • J. Heath
    • 1
    • 2
  • E. González
    • 1
    • 2
  • A. Wedin
    • 1
    • 2
  • M. Prytz
    • 2
    • 3
  • D. Asplund
    • 1
    • 2
  • E. Haglind
    • 1
    • 2
  1. 1.Department of SurgerySahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital/Östra campusGothenburgSweden
  2. 2.SSORG–Scandinavian Surgical Outcomes Research GroupGothenburgSweden
  3. 3.Norra Älvsborgs LänssjukhusTrollhättanSweden

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