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Patient-Reported Outcome after Ostomy Surgery for Chronic Constipation.

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eMediNexus    17 July 2018

The goal of a new study published in the European Journal of Wound, Ostomy, and Continence Nursing was to describe experiences of, and to evaluate psychosocial and health-related quality of life of individuals undergoing ostomy surgery for severe, chronic constipation. This study entailed a search of the local ostomy archive and the electronic hospital episode statistics database in a large tertiary referral center. Study outcomes were evaluated retrospectively using clinical notes and prospectively through the City of Hope Ostomy Quality of Life questionnaire, Medical Outcomes Study Short Form-36, Hospital Anxiety and Depression tool, and a specially designed ostomy-specific questionnaire. The participants were patients, with a median age of 44 years, 20 of which underwent ileostomy and 4 had undergone colostomy over a 13-year period. Among these 91% were females; 41% of the patients underwent laparoscopic surgery, 54% underwent open procedures, and 1 was converted from laparoscopic to open surgery. The mean length of stay and the rate of complication were comparable between the 2 approaches. Overall, 58.3% patients responded to the postal questionnaires. Adverse effects on health-related quality of life in the physical and social well-being were reported. In addition, 86% of the respondents reported psychological morbidity associated with ostomy. Whereas, more than 70% of the respondents were satisfied with their quality of life on a mean follow-up of 17 months, despite a 20% reoperation rate. From the findings, it was concluded that ostomy is a justified last-resort treatment option in selected individuals with severe, chronic constipation. Hence, patients should be informed about the negative effects of ostomy on health-related quality of life and the associated risk of complications.

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