Quality of life after restorative proctocolectomy for ulcerative colitis: Preoperative status and long-term results

✍ Scribed by Mirjam Tariverdian; Christine Leowardi; Ulf Hinz; Thilo Welsch; Jan Schmidt; Peter Kienle

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 202 KB
• Volume: 13
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20175

✦ Synopsis

Background:

Restorative proctocolectomy has become the surgical procedure of choice in patients with ulcerative colitis. only smaller studies have compared postoperative to preoperative quality of life (qol).

Methods:

Patients with ulcerative colitis who had undergone restorative proctocolectomy at least 5 years before and who had filled out a disease-specific validated questionnaire (gastrointestinal quality of life index, giqli) prior to surgery (n = 128) were included into this follow-up study. factors potentially influencing qol at the time of operation were investigated with regard to pre- and postoperative qol in univariate and multivariate analysis.

Results:

A total of 105 patients responded (82%). qol at least 5 years after colectomy was significantly improved compared to the preoperative situation (109 versus 75). this improvement was evident in all 5 dimensions (p < 0.0001). the colitis activity index (cai) (p < 0.00001), a shorter duration of the disease (p < 0.05), and a 3-staged procedure (<0.001) were negatively correlated with preoperative qol, whereas neoplasia (p < 0.001) was positively correlated. colectomy was the reason for most of the increase in qol. ileostomy closure resulted in a further improvement in 3 of 5 dimensions but not in overall qol. uni- and multivariate analysis of the difference in qol before and 5 years after colectomy revealed cai, the type of operation (both p < 0.001), and neoplasia as significant factors (p < 0.05).

Conclusions:

The patients in the worst clinical situation profit the most from restorative proctocolectomy.