Patient Preferences and Concerns Regarding Stoma Formation Versus Sphincter-Sparing Surgery in Rectal Cancer : Stoma Formation Versus Sphincter-Sparing Surgery in Rectal Cancer

Farrukh Ozair Shah; Hussain Jan Abbasi; Tilal Ahmad Raza; Hajra Imtiaz

doi:10.54393/pjhs.v7i7.3857

Authors

Farrukh Ozair Shah Department of General Surgery, Hayatabad Medical Complex, Peshawar, Pakistan
Hussain Jan Abbasi Department of Colorectal Surgery, Khyber Medical College, Peshawar, Pakistan
Tilal Ahmad Raza Department of Surgery, Pilgrim Hospital Boston, United Kingdom
Hajra Imtiaz Department of Dermatology, Life Care Hospital and Research Centre. Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i7.3857

Keywords:

Rectal Cancer, Stoma, Sphincter Preservation, Patient Preference, Abdominoperineal Resection

Abstract

The outcome of the decision between stoma construction and sphincter-sparing procedures is critical to the quality of life of the patients after a rectal cancer operation. In a socio-culturally diverse society like Pakistan, clinical outcomes are significant to the surgeon to reach a decision, but the views of the patients are significant as well. Objectives: To assess the preferences and concerns of rectal cancer patients regarding permanent stoma formation versus sphincter-preserving surgery in Khyber Pakhtunkhwa (KPK), Pakistan. Methods: This analytical cross-sectional study was carried out in the Department of General Surgery, Hayatabad Medical Complex, Peshawar, between January 2022 and December 2024. A total of 250 patients with rectal cancer were enrolled. The final analysis included 220 patients after excluding those who had undergone previous surgery (n=12), cognitive impairment (n=8), recurrent rectal cancer (n=6), and those who refused participation (n=4). Results: Among 220 respondents, 63.6% preferred sphincter-sparing surgery and 36.4% preferred abdominoperineal resection (APR). Female gender (p<0.069), rural residence (p=0.024), and a high concern level (p<0.001) were significant predictors of preference for APR, while knowledge of stoma was associated with lower odds of APR preference (p<0.012). Higher education (p=0.165) and age (p=0.271) were not statistically significant. Conclusions: Psychosocial, informational, and demographic factors all affect patient preferences for rectal cancer surgery. Patients with greater preoperative concerns, female gender, and those who lived in rural areas were all linked to a stoma favor. However, prior experience with stoma care was protective of this choice.

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