Outcomes and Quality of Life of Patients with a Digestive Stoma in Sub-Saharan Africa: Case of the Yaounde Central Hospital, Cameroon

Abstract

Introduction: The installation of a digestive stoma involves changes affecting all aspects of the patients’ lives. The objective of this study was to determine the impact of a digestive stoma on the quality of life of patients operated on at the Yaounde Central Hospital (YCH). Patients and Methodology: We conducted a prospective descriptive study over a period of 12 months from June 2018 to May 2019 in all patients with a digestive stoma for at least 3 months operated on at the YCH. The follow-up was done within 12 months. Quality of life was assessed using the stoma QOL (quality of life) and self-image using the BIS (Body Image Scale). Results: We collected a total of 34 patients, of whom 22 were male, giving an M/F sex ratio of 1.8. The average age of the patients was 42.8 years. The indications were tumoral in 44.11% of cases (n = 15) and non-tumoral in 55.88% of cases (n = 19). The colon was the most frequently ablated organ (n = 26) with 76.5% of colostomies. The complication rate was 67.6%. Stomal oedema was the most common early complication with 38.2% of cases. All patients used colostomy bags. The average time to return to sexual activity was 8 months for men and 9 months for women. 85.3% of the patients had an average impairment of quality of life according to the Stoma Quality of Life Scale. According to the Body Image Scale, 73.5% of the patients had a moderate dissatisfaction with their self-image. Conclusion: The realization of a digestive stoma imposes a long-term follow-up especially on the psychological level in order to allow the empowerment of the patients who all have a modification of their quality of life and their self-image.