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Symptom load and individual symptoms before and after repair of parastomal hernia: a prospective single centre study
Author(s) -
Krogsgaard M.,
Pilsgaard B.,
Borglit T. B.,
Bentzen J.,
Balleby L.,
Krarup P.M.
Publication year - 2017
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13403
Subject(s) - medicine , interquartile range , surgery , hernia , stoma (medicine) , prospective cohort study
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.