Life with a stoma across five European countries—a cross-sectional study on long-term rectal cancer survivors

Abstract

Purpose Stoma-related problems are known to be important to patients and potentially affect everyday life. The prevalence of stoma-related problems in rectal cancer survivors remains undetermined. This study aimed to examine aspects of life with a long-term stoma, stoma management, and stoma-related problems and explore the impact of stoma-related problems on daily life. Methods In total, 2262 patients from 5 European countries completed a multidimensional survey. Stoma-related problems were assessed using the Colostomy Impact score. Multivariable regression analysis, after adjusting for potential confounding factors, provided odds ratio (OR) and 95% confidence intervals (CI) for stoma-related problems' association with restrictions in daily life. ResultsThe 2262 rectal cancer survivors completed the questionnaire at a median of 5.4 years (interquartile range 3.8-7.6) after stoma formation. In the total sample, leakage (58%) and troublesome odour (55%) were most prevalent followed by skin problems (27%) and pain (21%). Stoma-related problems were more prevalent in patients with parastomal bulging. A total of 431 (19%) reported feeling restricted in daily activities in life with a stoma. Leakage, odour, skin problems, stool consistency, and frequent appliance changes were significantly associated with restrictions in daily life. The highest risk of experiencing restrictions was seen for patients having odour ) more than once a week and skin problems ). Conclusion In this large cohort with rectal cancer, stoma-related problems were highly prevalent and impacted daily life. Supportive care strategies should entail outreach to patients with a long-term stoma.

Changes in the quality of life of adults with an ostomy during the first year after surgery as part of the Best Practice Spotlight Organisation® Programme

“…Another concern was needing to know where the nearest toilet is or the limited choice of clothes that they can wear because of the pouch. These aspects are closer to the personal rather than the social dimension—a finding that is consistent with other European studies—and were more prevalent among women 36 . However, it is important to note that these aspects improved the most from the second to the third follow‐up, which highlights the personalised work carried out by the nurses in providing education on the safety of the pouch seal—which is key to avoiding urinary leaks as well as irritation of the peristomal skin— and allowing patients to return progressively to their daily routine, as reported in other studies 35 .…”

The Quality of Life of Patients with Colorectal Carcinoma and Stoma

“…The impact of stoma on patients' quality of life was explored in many dimensions. The stoma-related physical problems, including irritated parastomal skin and unpleasant odor, noted in our study, were also reported by other researchers (19,27,28).…”

A retrospective evaluation of short-term results from colonic stenting as a bridge to elective surgery versus emergency surgery for malignant colonic obstruction

“…Cirocchi et al reported that there was no advantage of SEMS placement for malignant obstruction of left-sied colon in terms of complications and postoperative mortality 13 , but it can increase the primary anastomosis rate and reduce the stoma. This is critical because it can affect the quality of life of the patient and thus have an impact on the overall health of the patient 14 . There were no postoperative deaths in this study, which may be related to the small sample size.…”