The impact of intestinal stoma formation on patient quality of life after emergency surgery—a systematic review

MacDonald, S., Wong, L.‐S., John‐Charles, R., McKee, T., Quasim, T. and Moug, S. (2023) The impact of intestinal stoma formation on patient quality of life after emergency surgery—a systematic review. Colorectal Disease, (doi: 10.1111/codi.16603) (PMID:37208806) (Early Online Publication)

Abstract

Aim Elective stoma formation has a negative effect on patient quality of life (QoL), with a potential detrimental impact on body image, confidence and social functioning being shown previously. However, the impact of emergency stoma formation on QoL has been explored less frequently. This systematic review aims to synthesize all available literature exploring QoL via patient-reported outcome measures. Methods A search strategy was implemented on 24 November 2022 across Embase, MEDLINE, PsycInfo and the Cochrane Library database after registration on PROSPERO (CRD42022370606). Studies were included if they used a standardized patient-reported outcome measure, had more than five emergency stoma patients, age > 18 years and were fully published in English. Two of three independent researchers screened articles, extracted data and performed quality assessment using the Newcastle−Ottawa Scale and the Cochrane risk of bias tool. Results In all, 1775 articles were screened, with 16 included in the systematic review. This included 1868 emergency stoma patients (men:women 0.53; median age 64.6 years) followed up for a median of 12 months. Patients who had a Hartmann's procedure for perforated diverticulitis had poorer QoL than those who underwent primary anastomosis. There was a negligible difference in QoL between those who had a colonic stent for obstructing colorectal cancer compared with those who underwent emergency stoma formation. Female sex, end stoma formation and ileostomy formation were all identified as risk factors for poorer QoL. Conclusion Patients undergoing emergency stoma surgery have marginally poorer QoL compared with those undergoing similar procedures without stoma formation. Further work is required to identify risk factors associated with this and also to compare QoL after stoma reversal.

• Item Type: Articles
• Additional Information: This research has been partially funded by the Emergency Laparotomy and Laparoscopic Scotland Audit fellowship (reference number 2083546).
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Quasim, Professor Tara and Moug, Ms Susan
• Authors: MacDonald, S., Wong, L.‐S., John‐Charles, R., McKee, T., Quasim, T., and Moug, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Colorectal Disease
• Publisher: Wiley
• ISSN: 1462-8910
• ISSN (Online): 1463-1318
• Published Online: 19 May 2023
• Copyright Holders: Copyright © 2023 Association of Coloproctology of Great Britain and Ireland
• First Published: First published in Colorectal Disease 2023
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher