Impact of ostomy on quality of life in patients with colorectal cancer: A systematic review and meta-analysis

Abstract

[EN]Background/Objectives: This systematic review and meta-analysis evaluate the impact of ostomy on quality of life in patients with colorectal cancer, synthesizing evidence from case-control and interventional studies, and to assess the consistency, robustness, and clinical implications of the findings. Methods: A systematic search of PubMed, Web of Science, Scopus, and the Cochrane Library was conducted for studies published up to 21 September 2025. Eligibility criteria encompassed cases-control studies comparing ostomized versus non-ostomized colorectal cancer patients and interventional studies assessing quality of life before and after ostomy creation. Data extraction included study design, population characteristics, quality of life outcomes, and main findings. Results: A total of 5841 records were identified, with 71 full-text articles assessed and six studies meeting inclusion criteria. The random-effects meta-analysis using the REML estimator yielded a pooled effect size of -0.29 (95% CI: -0.38 to -0.20; p < 0.001), indicating significantly lower quality of life in ostomized patients. No heterogeneity was observed (τ2 = 0; I2 = 7%). Quality assessment indicated that 66.7% of studies were high quality and 33.3% intermediate. Sensitivity analyses confirmed robustness, as exclusion of influential studies did not alter results. Conclusions: Ostomy significantly reduces quality of life in colorectal cancer patients. Psychosocial and emotional challenges, including body image concerns and social limitations, contribute to this impact. These findings emphasize the need for comprehensive care and targeted interventions to enhance adaptation, social reintegration, and overall well-being in ostomized patients.