Skip to main content
Log in

Parastomal Hernia: Impact on Quality of Life?

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Introduction

Parastomal hernia (PH) is a frequent complication after end-colostomy formation. PH may negatively influence the quality of life in end-colostomy patients. Our study investigates the quality of life and body image (BI) in patients with an end-colostomy.

Methods

We conducted a cross-sectional study of end-colostomy patients in two different hospitals. Patients were included if they had received a Hartmann procedure or abdominal perineal resection between 2004 and 2011. Patients were invited to the outpatient clinic for clinical examination to determine if a PH was present and were asked to fill out the Short form 36, EuroQol-5D, and body image questionnaire (BIQ).

Results

One-hundred-and-fifty patients were eligible for the study; 139 filled out the questionnaires, of which 79 (56.8 %) had developed a PH. A linear multivariate regression showed PH caused a decrease in physical functioning (difference −10.2, p = 0.033) and general health (difference −9.0, p = 0.021), increase in pain (difference −11.3, p = 0.009) and decrease in the overall physical component score (difference −4.8, p = 0.020). The BIQ showed that PH increased the shame of the scar (difference −0.4, p = 0.010). Having an incisional hernia simultaneously decreased patients’ scoring of the scar in the BIQ (difference −0.99, p = 0.015).

Discussion

PHs cause significant decreases in quality of life and BI of patients. Counseling of patients towards PH and prevention of PH should therefore be of more concern in surgical departments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bafford AC, Irani JL (2013) Management and complications of stomas. Surg Clin North Am 93(1):145–166

    Article  PubMed  Google Scholar 

  2. Shabbir J, Britton DC (2010) Stoma complications: a literature overview. Colorectal Dis 12(10):958–964

    Article  CAS  PubMed  Google Scholar 

  3. Carne PW, Robertson GM, Frizelle FA (2003) Parastomal hernia. Br J Surg 90(7):784–793

    Article  CAS  PubMed  Google Scholar 

  4. Cheung MT (1995) Complications of an abdominal stoma: an analysis of 322 stomas. Aust N Z J Surg 65(11):808–811

    Article  CAS  PubMed  Google Scholar 

  5. Nastro P, Knowles CH, McGrath A, Heyman B, Porrett TR, Lunniss PJ (2010) Complications of intestinal stomas. Br J Surg 97(12):1885–1889

    Article  CAS  PubMed  Google Scholar 

  6. Martin L, Foster G (1996) Parastomal hernia. Ann R Coll Surg Engl 78(2):81–84

    PubMed Central  CAS  PubMed  Google Scholar 

  7. Chambers SK, Meng X, Youl P, Aitken J, Dunn J, Baade P (2012) A five-year prospective study of quality of life after colorectal cancer. Qual Life Res 21(9):1551–1564

    Article  PubMed  Google Scholar 

  8. Pachler J, Wille-Jørgensen P (2012) Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 12:CD004323

    PubMed  Google Scholar 

  9. van Ramshorst GH, Eker HH, Hop WC, Jeekel J, Lange JF (2012) Impact of incisional hernia on health-related quality of life and body image: a prospective cohort study. Am J Surg 204(2):144–150

    Article  PubMed  Google Scholar 

  10. Kald A, Juul KN, Hjortsvang H, Sjödahl RI (2008) Quality of life is impaired in patients with peristomal bulging of a sigmoid colostomy. Scand J Gastroenterol 43(5):627–633

    Article  PubMed  Google Scholar 

  11. Ripoche J, Basurko C, Fabbro-Perray P, Prudhomme M (2011) Parastomal hernia. A study of the French federation of ostomy patients. J Visc Surg 148(6):e435–e441

    Article  CAS  PubMed  Google Scholar 

  12. Timmermans L, Deerenberg EB, Lamme B, Jeekel J, Lange JF (2014) Parastomal hernia is an independent risk factor for incisional hernia in patients with end colostomy. Surgery 155(1):178–183

    Article  PubMed  Google Scholar 

  13. The EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208

    Article  Google Scholar 

  14. Brooks R (1996) EuroQol: the current state of play. Health Policy 37(1):53–72

    Article  CAS  PubMed  Google Scholar 

  15. McHorney CA, Ware JE, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31(3):247–263

    Article  CAS  PubMed  Google Scholar 

  16. McHorney CA, Ware JE, Lu JF, Sherbourne CD (1994) The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32(1):40–66

    Article  CAS  PubMed  Google Scholar 

  17. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  18. Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA (1998) Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12(11):1334–1340

    Article  CAS  PubMed  Google Scholar 

  19. Dunker MS, Bemelman WA, Slors JF, van Duijvendijk P, Gouma DJ (2001) Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. Dis Colon Rectum 44(12):1800–1807

    Article  CAS  PubMed  Google Scholar 

  20. Kasparek MS, Hassan I, Cima RR, Larson DR, Gullerud RE, Wolff BG (2011) Quality of life after coloanal anastomosis and abdominoperineal resection for distal rectal cancers: sphincter preservation vs quality of life. Colorectal Dis 13(8):872–877

    Article  CAS  PubMed  Google Scholar 

  21. Vermeulen J, Gosselink MP, Busschbach JJ, Lange JF (2010) Avoiding or reversing Hartmann’s procedure provides improved quality of life after perforated diverticulitis. J Gastrointest Surg 14(4):651–657

    Article  PubMed Central  PubMed  Google Scholar 

  22. Mols F, Lemmens V, Bosscha K, van den Broek W, Thong MS (2014) Living with the physical and mental consequences of an ostomy: a study among 1-10-year rectal cancer survivors from the population-based PROFILES registry. Psychooncology. 23(9):998–1004

    Article  PubMed  Google Scholar 

  23. Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Hölzel D (2003) Quality of life in rectal cancer patients: a four-year prospective study. Ann Surg 238(2):203–213

    PubMed Central  PubMed  Google Scholar 

  24. Israelsson LA (2008) Parastomal hernias. Surg Clin North Am 88(1):113–125 ix

    Article  PubMed  Google Scholar 

  25. Canova C, Giorato E, Roveron G, Turrini P, Zanotti R (2013) Validation of a stoma specific quality of life questionnaire in a sample of patients with colostomy or ileostomy. Colorectal Dis 15(11):e692–e698

    Article  CAS  PubMed  Google Scholar 

  26. Osoba D, Bezjak A, Brundage M et al (2005) Analysis and interpretation of health-related quality-of-life data from clinical trials: basic approach of The National Cancer Institute of Canada Clinical Trials Group. Eur J Cancer 41(2):280–287

    Article  PubMed  Google Scholar 

  27. Stephens R (2004) The analysis, interpretation, and presentation of quality of life data. J Biopharm Stat 14(1):53–71

    Article  PubMed  Google Scholar 

  28. Brandsma HT, Hansson BM, V-Haaren-de Haan H, Aufenacker TJ, Rosman C, Bleichrodt RP (2012) PREVENTion of a parastomal hernia with a prosthetic mesh in patients undergoing permanent end-colostomy; the PREVENT-trial: study protocol for a multicenter randomized controlled trial. Trials 13:226

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lucas Timmermans.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

van Dijk, S.M., Timmermans, L., Deerenberg, E.B. et al. Parastomal Hernia: Impact on Quality of Life?. World J Surg 39, 2595–2601 (2015). https://doi.org/10.1007/s00268-015-3107-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-015-3107-4

Keywords

Navigation