Quality of life and patient’s expectations after closure of a temporary stoma

Abstract

Little is known about the changes in quality of life following reversal of a temporary loop ileostomy after rectal cancer surgery. We therefore conducted a prospective study assessing physical symptoms, quality of life, problems in everyday life, and patient's expectations and complaints. We investigated 35 patients who received a temporary stoma after colorectal surgery between 15/11/2002 and 15/11/2003. The patients were followed up for 1 year. Quality of life was assessed using the Short-Form 36 (SF-36) and the Gastrointestinal Quality of Life Index (GLQI). In addition, we performed a semi-structured interview that assessed quality of life, function, patient's expectations, and complaints. The interviews showed a significant improvement in body image and leisure activities while the questionnaires showed no change in qol. Conversely, there was a significant increase in gastrointestinal problems that persisted until 1 year after primary surgery. An increasing proportion of patients stated that they felt worse than they expected after stoma closure. That was accompanied by an increased number of complaints about the hospital and the medical staff. Although from the surgeon's point of view, stoma closure is only a minor procedure, it causes significant functional problems for the patients that lead to considerable dissatisfaction. Other than usually presupposed, there is no general improvement in quality of life and everyday life after stoma closure. Therefore, thorough preoperative counseling about the consequences of stoma reversal is mandatory.