[Long-term quality of life after continence-preserving proctocolectomy for ulcerative colitis and familial adenomatous polyposis].
After ileal pouch-anal anastomosis in patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP), quality of life is a relevant factor for the assessment of the operation's success, in addition to postoperative morbidity and functional outcome. Between 1982 and 1995 restorative proctocolectomy was performed in 453 patients (UC: n = 332; FAP: n = 121) at the Department of Surgery, University of Heidelberg. We studied postoperative quality of life through a long-term follow-up study (median follow-up time 43.2 months). This study 1 year or more following ileostomy closure of persons who had undergone J-pouch anastomosis (n = 243 total; UC n = 185, FAP n = 58) revealed that at the time of follow-up, the underlying disease (UC versus FAP) and successfully treated complications are without influence on the quality of life. The patient's age (P < 0.01) and the presence of unsuccessfully treated complications (P < 0.0001) showed a significant influence on the quality of life. There was a distinct relation between the functional index and the quality of life index (coefficient of correlation r = -0.714). However, quality of life, comparable to that of healthy controls, can be achieved with UC and FAP patients by restorative proctocolectomy only if postoperative complications can be avoided or are successfully treated.
Heuschen
U A
UA
Chirurgische Klinik und Poliklinik, Universität Heidelberg.
Heuschen
G
G
Rudek
B
B
Hinz
U
U
Stern
J
J
Herfarth
C
C
D000203:Activities of Daily Living / Q000145:classification; D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery*; D005242:Fecal Incontinence / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D016737:Proctocolectomy, Restorative; D011788:Quality of Life
Lebensqualität im Langzeitverlauf nach kontinenzerhaltender Proktocolektomie wegen Colitis ulcerosa und familiärer adenomatöser Polyposis.