Final Royal Surrey patient joins study into link between surgical technique and common complication
The final Royal Surrey patient has joined a national study to investigate if the way a surgeon creates a stoma can influence the likelihood of a patient developing a hernia.
Stoma surgery is used in the treatment of a range of conditions, such as bowel cancer and Crohn’s disease. It involves diverting the bowel or bladder through a surgically created hole – known as a stoma – so that body waste can be collected in an external pouch or bag. More than 120,000 people in the UK have a stoma – that’s one in 550 people.
A parastomal hernia is a common complication of stoma surgery, it occurs when the edges of the stoma come away from the muscle, allowing abdominal contents – usually a section of bowel – to bulge out. These can cause pain and stoma contents to leak.
There are a number of different surgical methods to creating a stoma and it is thought that, along with patient factors, these may influence the development of parastomal hernias. The CIPHER study, led by University of Bristol, is investigating whether the way in which a surgeon creates a stoma influences the development of a parastomal hernia.
The Bristol study team is working with hospitals around the UK to collect records and technical details on how surgeons perform the stoma. They will have access to future scans and clinical follow-up details to monitor the incidence of symptomatic and asymptomatic parastomal hernias. They will assess any associations to surgical technique or patient-related clinical details.
Principal Investigator for the Royal Surrey site Andrea Scala, who is also a consultant colorectal surgeon,said:
“Parastomal hernias are extremely common and can cause pain and discomfort with a big impact on quality of life. This study will give us insight into how the way we create a stoma affects the risk of patients suffering from this complication.
“The Bristol study team will be analysing stoma surgical variants including the size and shape of the incision in the body wall, the use of mesh when the stoma is formed and, if a mesh is used, exactly what type of mesh and how the mesh is used. All these factors can potentially be important determinants in the development of parastomal hernias.”