Impact of incisional hernia on quality of life after colorectal cancer surgery - results of the Rein4CeTo1 randomized clinical trial.

PURPOSE: To evaluate quality of life (QoL), abdominal wall pain and discomfort 1 and 3 years after colorectal cancer (CRC) surgery in patients with and without incisional hernia (IH) and perform a risk factor analysis for impaired QoL. METHODS: Longitudinal observational study with patients included in the randomized controlled trial, Rein4CeTo1, carried out 2017-2021. Patients underwent CT-scans 12 ± 3 and 36 ± 3 months after surgery, scrutinized for diagnosis of IH. General health was evaluated using the EQ-5D-5L questionnaire. For QoL related to IH and overall abdominal wall symptoms a slightly modified version of the Ventral Hernia Pain Questionnaire (VHPQ) was used. Potential risk factors of impaired QoL were investigated with multivariable linear regression analysis. RESULTS: Of 160 randomized patients, 134 were eligible for 1-year follow-up and 119/134 (89%) answered the questionnaires. Corresponding numbers at 3 years was 81/101 (80%). The EQ-5D-5L results were similar at 1 and 3 years for patients with and without IH (p = 0.276 1 year, p = 0.404 3 years). The VHPQ concluded low frequency of pain, stiffness in the abdominal wall and other discomforting symptoms without differences between patients with and without IH. In multivariable linear regression stoma was an independent risk factor for impaired general QoL at 3 years, p < 0.005. CONCLUSION: In this study, comparing QoL 1 and 3 years after CRC surgery, we could not find a statistically significant difference in patients developing an IH compared to those who did not. The presence of a stoma was an independent risk factor for impaired general QoL after 3 years.