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.
Dr Peter Kienle and colleagues from Germany undertook a follow-up study of 128 patients with ulcerative colitis who had undergone restorative proctocolectomy at least 5 years before.
The patients had filled out a disease-specific validated questionnaire (Gastrointestinal Quality of Life Index) prior to surgery.
|Colectomy was the reason for most of the increase in quality of life|
|Inflammatory Bowel Diseases|
Factors potentially influencing quality of life at the time of operation were investigated.
The research team assessed pre- and postoperative quality of life using univariate and multivariate analysis.
The researcher reported that a total of 105 patients responded.
The team found that quality of life at least 5 years after colectomy was significantly improved compared to the preoperative situation .
This improvement was evident in all 5 dimensions.
The Colitis Activity Index , a shorter duration of the disease, and a 3-staged procedure were negatively correlated with preoperative quality of life.
However, the researchers observed that neoplasia was positively correlated with preoperative quality of life.
The team found that colectomy was the reason for most of the increase in quality of life.
Ileostomy closure resulted in a further improvement in 3 of 5 dimensions but not in overall quality of life.
Uni- and multivariate analysis of the difference in quality of life before and 5 years after colectomy revealed Colitis Activity Index as a significant factor.
The team found that the type of operation, and neoplasia were also significant factors.
Dr Kienle's team concluded, "The patients in the worst clinical situation profit the most from restorative proctocolectomy."