The team investigated the long-term benefit of surgery on health-related quality of life (HRQL) in patients with inflammatory bowel disease.
They reported their findings in the May issue of Archives of Surgery.
139 consecutive patients undergoing surgery for IBD between 1994 and 2000 were prospectively investigated. Of these, 56 were diagnosed with Crohn's disease, and 83 with ulcerative colitis.
Patients with Crohn's disease underwent resections with or without stricturoplasties. All but 5 patients with ulcerative colitis underwent ileal pouch-anal anastomoses.
Health status was measured using the Health Status Questionnaire (HSQ) preoperatively, and then every 3 months postoperatively.
|After surgery, HRQL scores improved in both Crohn's and colitis patients.
|Archives of Surgery|
Preoperative HSQ scores were found to be very low in all 8 scales of the HSQ.
Postoperatively, HRQL measures improved significantly both in patients with Crohn's disease and ulcerative colitis, with scores equal to or better than published scores in the general population.
In patients with Crohn's disease, the scores improved significantly after surgical resection, and steadily increased, despite disease recurrence and re-operations.
The researchers found that the HRQL at last follow-up was equivalent to the general population.
The improvements were statistically significant in patients followed up for more than 1 year in 7 of 8 scales of the HSQ.
Dr Richard Thirlby, of the Virginia Mason Medical Center, Seattle, said on behalf of his colleagues, "These results confirm that HRQL is poor in patients with IBD referred for possible operation.
"Surgical resection resulted in significant improvement in HRQL, and, more importantly, the results were durable.
"With a follow-up period up to 6 years, the HRQL in this cohort was equal to or better than norms for the general population, both in patients with ulcerative colitis and with Crohn's disease."
"We believe these data justify aggressive surgical intervention in many patients with IBD, and support the prospective study of HRQL by surgeons treating patients with chronic diseases," he concluded.