title: Symptom load and individual symptoms before and after repair of parastomal hernia: a prospective single centre study.
abstract: OBJECTIVE
  The symptom load and individual symptoms before and after repair of parastomal hernia were investigated.
  
  
  METHODS
  Stoma-related symptoms were prospectively recorded before repair of a parastomal hernia and at 10 days and 6 months postoperatively: leakage, skin problems, difficulty with the appliance, limitation of activity, difficulty with clothing, cosmetic complaints, social restriction, erratic action of the stoma, a bearing-down sensation at the site of the stoma and pain. Episodes of intermittent bowel obstruction and difficulty with irrigation were also recorded. Patients were seen at 1, 2 and 3 years and were examined for recurrent parastomal herniation.
  
  
  RESULTS
  Of 131 consecutive patients referred to a specialized centre for treatment of parastomal bulging, 61 underwent parastomal hernia repair. Forty-eight patients were treated with the Sugarbaker technique. Six different symptoms were present in more than half the patients before surgery. The overall symptom load decreased significantly from a median of 4 [interquartile range (IQR) 2.5-6] preoperatively to 2 (IQR 1-3) on postoperative day 10 and 1 (IQR 0-2) at 6 months, P < 0.001. The number of symptoms decreased in 93% of patients; in 5% there was no change and in 2% symptoms increased. Skin problems and leakage were the only symptoms that were not significantly reduced. The overall recurrence rate of herniation was 5/48 (10%) at a median of 12 (IQR 6-24) months.
  
  
  CONCLUSIONS
  The preoperative symptom load was high and this fell after repair in over 90% of patients. Recurrence occurred in 10% of patients within 2 years of repair. The study emphasizes the importance of detailed knowledge of the symptoms of parastomal hernia when addressing and managing patients' problems and complaints.
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen NV, Denmark.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-6528-5639
authors.initials: M
authors.lastname: Krogsgaard
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen NV, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Pilsgaard
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen NV, Denmark.
authors.forename: T B
authors.initials: TB
authors.lastname: Borglit
authors.affiliation: Research Centre for Prevention and Health, Glostrup, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Bentzen
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen NV, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Balleby
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen NV, Denmark.
authors.forename: P M
authors.initials: PM
authors.lastname: Krarup
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy; D005260:Female; D006555:Hernia, Ventral / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007081:Ileostomy; D007415:Intestinal Obstruction / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012871:Skin Diseases / Q000503:physiopathology; D058992:Social Participation; D054047:Surgical Stomas
keywords: Parastomal hernia; Sugarbaker technique; repair; stoma; symptom load; symptoms