Symptom load and individual symptoms before and after repair of parastomal hernia: a prospective single centre study

M Krogsgaard, B Pilsgaard, T B Borglit, J Bentzen, L Balleby, P M Krarup

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    AIM: The symptom load and individual symptoms before and after repair of parastomal hernia were investigated.

    METHOD: Stoma-related symptoms were prospectively recorded before repair of a parastomal hernia and at 10 days and 6 months postoperatively: leakage, skin problems, difficulty with the appliance, limitation of activity, difficulty with clothing, cosmetic complaints, social restriction, erratic action of the stoma, a bearing-down sensation at the site of the stoma and pain. Episodes of intermittent bowel obstruction and difficulty with irrigation were also recorded. Patients were seen at 1, 2 and 3 years and were examined for recurrent parastomal herniation.

    RESULTS: Of 131 consecutive patients referred to a specialized centre for treatment of parastomal bulging, 61 underwent parastomal hernia repair. Forty-eight patients were treated with the Sugarbaker technique. Six different symptoms were present in more than half the patients before surgery. The overall symptom load decreased significantly from a median of 4 [interquartile range (IQR) 2.5-6] preoperatively to 2 (IQR 1-3) on postoperative day 10 and 1 (IQR 0-2) at 6 months, P < 0.001. The number of symptoms decreased in 93% of patients; in 5% there was no change and in 2% symptoms increased. Skin problems and leakage were the only symptoms that were not significantly reduced. The overall recurrence rate of herniation was 5/48 (10%) at a median of 12 (IQR 6-24) months.

    CONCLUSION: The preoperative symptom load was high and this fell after repair in over 90% of patients. Recurrence occurred in 10% of patients within 2 years of repair. The study emphasizes the importance of detailed knowledge of the symptoms of parastomal hernia when addressing and managing patients' problems and complaints.

    OriginalsprogEngelsk
    Sider (fra-til)200-207
    Antal sider8
    TidsskriftColorectal Disease
    Vol/bind19
    Udgave nummer2
    DOI
    StatusUdgivet - feb. 2017

    Bibliografisk note

    Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

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