Post-operative oncological and psychological evaluation of patients with colostomy for colorectal cancer

BACKGROUND: The therapeutic arsenal for colorectal cancer is largely made up of surgery. In digestive tumors, ostomy devices induce loss of function and control. This medical device generates changes that affect all aspects of patients' lives. This study evaluates the postoperative follow-up from the oncological point of view and the psychological impact of colostomy on the quality of life of patients with colorectal cancer, analyzing any complications or relapses, and the high risk of self-concept disorder and social isolation. METHODS: The aim of the work was to identify all the surgeries for colorectal cancer performed in the Federico II University Hospital of Naples, from 2018 to 2021, and among them how many had been packaged a colostomy. We then analyzed how many patients had been evaluated 12 months after surgery, with a transanal endoscopy or transtomy, and the percentage of any complications or relapses. The same patients who underwent endoscopic control were also evaluated psychologically, to analyze how they lived the packaging of the ostomy and how it had affected the quality of life. RESULTS: At endoscopic control, diversion colitis phenomena and few cases of stoma stenosis and stomatitis were detected. No case of neoplastic recurrence. From the psychological point of view, the problems detected were in particular the alteration of body image, the loss of sphincter control, embarrassment and shame for the bad smell, impairment of sexuality and difficulties in the couple relationship and social contacts, anxiety, depression and loneliness. CONCLUSIONS: The post-operative evaluation of the ostomy patient following colorectal cancer requires endoscopic control to suddenly detect recurrences and complications and psychological support that improves their quality of life.

Automated summary

This study evaluates the postoperative follow-up and psychological impact of colostomy on the quality of life of patients with colorectal cancer. The results show that complications such as diversion colitis, stoma stenosis, and stomatitis were detected during endoscopic control. From a psychological perspective, patients experienced body image alteration, loss of sphincter control, embarrassment and shame, impairment of sexuality and social relationships, as well as anxiety, depression, and loneliness.