title: Functional outcomes and quality of life after anorectal surgery.
abstract: There is a paucity of information examining quality of life (QOL) and functional results after anorectal surgery. We aim to prospectively evaluate postoperative QOL, pain, functional outcomes, and satisfaction for a large cohort of patients undergoing anorectal surgery. Data were prospectively  accrued for consecutive patients undergoing anorectal operations from June 2009 to September 2010. Preoperative and postoperative electronic questionnaires were completed. QOL was evaluated by the European QOL index (EQ-5D) and functional results with the Fecal Incontinence Severity Index  (FISI). Satisfaction was assessed: 1) Are you satisfied with surgery? 2) Would you recommend surgery to others? Responses were reported: 1 to 5 (1 = not at all; 5 = a lot). Pain was scored: 1 (no pain) to 10 (worst). One hundred ninety-five patients, 111 (56.9%) females, median age 44 years  (range, 18 to 93 years), underwent anorectal surgery for abscess, condyloma, fissure, fistula, hemorrhoids, incontinence, pilonidal disease, pouch problems, tumors, and prolapse. Overall, pain improved significantly with improved QOL (P = 0.03). This correlated with overall postoperative  satisfaction (92.4%). A total of 87.7 per cent of patients would recommend their surgery to others. The FISI was similar pre- and postoperatively (P = 0.18) and did not worsen postoperatively irrespective of surgical indication and procedure. Most patients were satisfied after anorectal  surgery, which correlated with improved pain and QOL. Functional outcomes did not worsen. This will help counsel patients preoperatively and allay anxiety about postoperative function.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Alexis
authors.initials: A
authors.lastname: Grucela
authors.forename: Brooke
authors.initials: B
authors.lastname: Gurland
authors.forename: Ravi P
authors.initials: RP
authors.lastname: Kiran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001004:Anus Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012002:Rectal Diseases / Q000601:surgery*; D011795:Surveys and Questionnaires