LAUSR

In the context of improving colorectal cancer outcomes, post-survivorship quality of life has become an important outcome measure. Parastomal hernias and their associated morbidity remain largely under-reported and under-appreciated. Despite their burden, conservative management is common. This study aims to provide a national overview on the current trends in parastomal hernia repairs (PHRs). All PHRs performed in the country between 1/2017 to 7/2022 were identified retrospectively from the National Quality Assurance and Improvement System (NQAIS) database. Anonymised patient characteristics and quality indices were extracted for statistical analysis. A total of 565 PHRs, 64.1% elective and the remainder emergent, were identified across 27 hospitals. The 8 national colorectal units performed 67.3% of all repairs. While 42.3% of PHRs were standalone procedures, reversal of Hartmann's procedure was the commonest simultaneous procedure in the remainder. The median age, ASA and Charlson Co-Morbidity Index were 64 years (24–97), 3(1–5) and 3(0–48) respectively. Mean length of stay (LOS) was 16.2 days (SD=29.8). 29.0% of patients had at least 1 emergency readmission in 12 months, with a corresponding 12% 30-day readmission rate. Linear regression analysis associated ASA (95% CI 0.58–16.1, p<0.035) and emergency admissions (95% CI 5.9–25.5, P<0.002) with a significantly longer LOS, with the latter also associated with more frequent emergency re-admissions (95% CI 0.18–0.82, p<0.002). Patients undergoing emergency PHR are subjected to longer stays and more frequent readmissions. A dedicated parastomal hernia registry will facilitate timely elective intervention, negating the undue morbidity and costs associated with emergency