Journal
COLORECTAL DISEASE
Volume 23, Issue 10, Pages 2681-2689Publisher
WILEY
DOI: 10.1111/codi.15842
Keywords
cancer; colorectal; functional; surgery
Categories
Funding
- Swedish Research Council [2017-01103]
- Swedish Cancer Society [CAN 2016/509, 19 0333 Pj]
- Swedish Society of Medicine [SLS693371]
- Health-care sub-committee of Region Vastra Gotaland [VGFOUREG-308861, VGFOUREG-374491, VGFOUREG-468731]
- ALF [ALFGBG-426501, ALFGBG-716581, ALFGBG-493341]
- Anna-Lisa and Bror Bjornssons Foundation
- Assar Gabrielsson Foundation
- Lion's Cancer Research Foundation of Western Sweden
- Mary von Sydow Foundation
- Ruth and Richard Julin's Foundation
- Gothenburg Medical Society
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The majority of rectal cancer patients who undergo colostomy surgery are not bothered by their stoma, but a subgroup of patients face difficulties in daily life, especially fear of leakage. Stoma-related bother is associated with overall stoma dysfunction, and the prediction accuracy for bother is low.
Aim The factors that influence a patient's experience of a colostomy are not known. The aim of this study was to characterise stoma function, stoma-related bother and acceptance among patients operated for rectal cancer and to investigate if there were any preoperative personal factors with predictive impact on long-term stoma-related bother. Methods The QoLiRECT (Quality of Life in RECTal cancer) study is a prospective multicentre study of patients with rectal cancer. This was a subgroup analysis of patients with a permanent colostomy with a 2-year follow-up. Penalised regression models with shrinkage estimation were used to predict the 1-and 2-year bother using baseline data. The predictive value and the importance of the included variables were evaluated using bootstrap resampling techniques. Results A total of 379 patients were included. Overall stoma acceptance was high and a majority of patients were not bothered by their stoma; 77% and 83% at 1 and 2 years, respectively. The subgroup of patients with stoma-related bother had a high prevalence of difficulties, especially fear of leakage, and a low stoma acceptance in daily life. Both clinical and personal factors were associated with stoma-related bother. The most important factors were quality of life and physical health, but the prediction accuracy was low. Conclusions Stoma-related bother was associated with overall stoma dysfunction. As stoma-related bother is a multifactorial problem, it was not possible to predict which patients will experience stoma-related bother. It is therefore of importance to prevent stoma-related symptoms and optimise stoma function to reduce long-term bother and increase stoma acceptance.
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