Open AccessQuality of life after restorative proctocolectomy for ulcerative colitis: Preoperative status and long‐term results
Author(s) -
Tariverdian Mirjam,
Leowardi Christine,
Hinz Ulf,
Welsch Thilo,
Schmidt Jan,
Kienle Peter
Publication year - 2007
Publication title -
inflammatory bowel diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.932
H-Index - 146
eISSN - 1536-4844
pISSN - 1078-0998
DOI - 10.1002/ibd.20175
Subject(s) - proctocolectomy , medicine , ulcerative colitis , colectomy , ileostomy , quality of life (healthcare) , multivariate analysis , univariate analysis , gastroenterology , surgery , disease , nursing
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. (Inflamm Bowel Dis 2007)