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Restorative proctocolectomy in patients with ulcerative colitis: a cross‐sectional D anish population study on function and quality of life
Author(s) -
Brandsborg S.,
Tøttrup A.,
Nicholls J.,
Laurberg S.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12270
Subject(s) - medicine , ulcerative colitis , proctocolectomy , quality of life (healthcare) , cross sectional study , inflammatory bowel disease , pouch , incidence (geometry) , population , gastroenterology , bowel function , fecal incontinence , surgery , disease , pathology , physics , nursing , environmental health , optics
Aim The study evaluated function and quality of life ( Q o L ) in all patients having restorative proctocolectomy ( RPC ) in D enmark for ulcerative colitis ( UC ) from 1980 to 2010. Inclusion of all patients in one country has never previously been achieved. Method All patients who had had a RPC in D enmark, from the first case in 1980 to the last case in 2010, were studied. A cross‐sectional questionnaire survey was performed, and function and Q o L were assessed using a standardized questionnaire – the S hort‐ F orm 36 ( SF 36) – and the inflammatory bowel disease questionnaire ( IBDQ ). Results The median duration of follow up was 11 (range, 1–30) years. Apart from deaths, pouch failures and research protection, data on function and Q o L were obtained from 1047 (85%) of 1229 patients who had a functioning pouch at the time of the investigation. More female patients than male patients experienced urgency (56% vs 44%, P = 0.0021). The median number of bowel movements per 24 h was 7 (range, 1–23) in female patients and 6 (range, 1–20) in male patients ( P < 0.001). Pad usage was more frequent among female patients than among male patients (62% vs 38%, P < 0.001). A higher incidence of major incontinence ( P = 0.009) and use of pads ( P = 0.01) was found among patients who had been operated on 21–30 years previously compared with those operated on 11–20 years previously. The prevalence of urgency was higher in patients who received surgery 0–10 years previously compared with 11–20 years previously ( P = 0.009). The total IBDQ score was higher in male patients than in female patients ( P < 0.001). Male patients scored higher in five of eight SF 36 domains ( P < 0.001). Conclusion Female patients had more urgency, a higher frequency of defaecation and higher pad usage. This was associated with a reduced Q o L . Nevertheless, RPC resulted in good function and a high degree of satisfaction in most patients.