Long-term quality of life after ileal pouch anal restorative proctocolectomy for ulcerative colitis

Salehimarzijarani, Babak; Jalaly, Niloofar Y; Dadvar, Zohreh; Hemmasi, Gholamreza; Ashrafi, Mandana; Zali, Mohammad Reza

doi:10.1007/s12664-012-0284-z

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…It is encouraging to see that despite the large number of colectomies, patient QoL did not appear to be adversely affected. This concurs with findings from other studies where surgery in UC patients did not result in adverse effects on QoL [26,27]. A recent study of 10-year long-term outcomes in UC patients following ileal pouch anal anastomosis similarly showed good QoL outcomes in most patients [28].…”

Section: Discussionsupporting

confidence: 90%

Quality of Life in Patients with Acute Severe Ulcerative Colitis: Long-Term Follow-Up Results from the CONSTRUCT Trial

Alrubaiy

Hutchings

Louca

et al. 2022

JPM

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Background: there is currently limited research examining the QoL of patients with Ulcerative colitis (UC) following treatment of acute severe colitis (ASUC). Objective: to examine the long-term QoL of ASUC patients enrolled in the CONSTRUCT trial following treatment of UC with infliximab or ciclosporin and to compare the differences in the QoL between the two drug treatments over time. Methods: The CONSTRUCT trial examined the cost and clinical effectiveness of infliximab and ciclosporin treatments for acute severe UC. We collected QoL questionnaire data from patients during the active trial period up to 36 months. Following trial completion, we contacted patients postannually for up to a maximum of 84 months. We collected QoL data using a disease-specific (CUCQ, or CUCQ+ for patients who had colectomy surgery) or generic (EQ5D-3L) questionnaire. We analysed QoL scores to determine if there was any difference over time and between treatments in generic or disease-specific QoL. Results: Following initial treatment with infliximab and ciclosporin, patients experienced a statistically significant improvement in both the generic and disease-specific QoL at three months. Generic scores remained fairly static for the whole follow-up period, reducing only slightly up to 84 months. Disease-specific scores showed a much sharper improvement up to 2 years with a gradual reduction in QoL up to 84 months. Generic and disease-specific QoL remained higher than baseline values. There was no significant difference between treatments in any of the QoL scores. Conclusions: Both infliximab and ciclosporin improve QoL following initial treatment for ASUC. QoL scores remain higher than at admission up to 84 months post-treatment.

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Section: Discussionsupporting

confidence: 90%

Quality of Life in Patients with Acute Severe Ulcerative Colitis: Long-Term Follow-Up Results from the CONSTRUCT Trial

Alrubaiy

Hutchings

Louca

et al. 2022

JPM

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“…Twelve studies assessed QoL in a variety of different patient populations, using a range of different methods and questionnaires (Table S2). Six studies assessed QoL in postoperative IPAA cohorts alone [23,25,26,30,33,48], two compared QoL before and after surgery for IPAA [28,54], two compared postoperative cohorts of IPAA to ileostomy [29,39] and two compared IPAA to continued medical therapy [42,53]. Due to the large variability in QoL questionnaires used, the variation in study populations and also inter-study variation of analysis of questionnaires, a formal synthesis of results was not possible.…”

Section: Quality Of Lifementioning

confidence: 99%

“…Two studies reported general health to be comparable to that of the general population [23,33] following IPAA surgery, whilst physical and mental health were reportedly lower than the general population [23]. Additionally, one study [48] reported QoL to be average or good in 97.4% of the cohort following IPAA surgery. Sexual desire and sexual satisfaction were reported to increase post-surgery [26], despite a different study reporting that there was no change in the quality of relationships after surgery [30].…”

Section: Quality Of Lifementioning

confidence: 99%

A systematic review and meta‐analysis of outcomes after elective surgery for ulcerative colitis

et al. 2020

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Aim Approximately 20%–30% of patients with ulcerative colitis (UC) will undergo surgery during their disease course, the vast majority being elective due to chronic refractory disease. The risks of elective surgery are reported variably. The aim of this systematic review and meta‐analysis is to summarize the outcomes after elective surgery for UC. Methods A systematic review was conducted that analysed studies reporting outcomes for elective surgery in the modern era (>2002). It was prospectively registered on the PROSPERO database (ref: CRD42018115513). Searches were performed of Embase and MEDLINE on 15 January 2019. Outcomes were split by operation performed. Primary outcome was quality of life; secondary outcomes were early, late and functional outcomes after surgery. Outcomes reported in five or more studies underwent a meta‐analysis of incidence using random effects. Heterogeneity is reported with I2, and publication bias was assessed using Doi plots and the Luis Furuya‐Kanamori index. Results A total of 34 studies were included (11 774 patients). Quality of life was reported in 12 studies, with variable and contrasting results. Thirteen outcomes (eight early surgical complications, five functional outcomes) were included in the formal meta‐analysis, all of which were outcomes for ileal pouch–anal anastomosis (IPAA). A further 71 outcomes were reported (50 IPAA, 21 end ileostomy). Only 14 of 84 outcomes received formal definitions, with high inter‐study variation of definitions. Conclusion Outcomes after elective surgery for UC are variably defined. This systematic review and meta‐analysis highlights the range of reported incidences and provides practical information that facilitates shared decision making in clinical practice.

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“…In fact, a surgical intervention is not always well-received by patients, who fear the process in itself and the occurrence of postoperative complications: the results of a survey published in 2007 revealed that, from 5,576 IBD patients (43.5% of whom with UC), 86.4% said they would rather try a new type of drug therapy then undergo surgery [17]. However, recent studies have demonstrated that surgery has generally a good outcome regarding the QoL of UC patients: Salehimarzijarani et al [18] have shown that 38.5 and 59% of patients who underwent an IPAA had a "good" (IBDQ between 151 and 199) and "regular" (IBDQ between 101 and 150) HRQoL, respectively, 5 years after the intervention. Moreover, Fazio et al [19] analyzed a large cohort of 3,707 patients, 79.7% of whom had UC, and determined that functional outcomes and QoL were good or excellent in 95% of the patients.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life in Patients with Moderate to Severe Ulcerative Colitis: Surgical Intervention versus Immunomodulatory Therapy

et al. 2019

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Ulcerative colitis (UC) can be managed with immunomodulation or surgery. We aimed to understand whether these strategies had a different impact on patients' healthrelated quality of life (HRQoL). Methods: This was a retrospective, cross-sectional study: patients who had a moderate to severe UC episode that prompted the utilization of immunomodulatory drugs or surgery were invited to complete a generic (short form [36] health survey [SF-36]) and a disease-specific (inflammatory bowel disease questionnaire [IBDQ]) survey. Results: We included 157 patients, 65 (41.4%) surgically treated. The therapeutic procedure had a minimal impact on HRQoL: only the social dimension of the IBDQ and the physical function component of the SF-36 were significantly different between the study arms-lower for the surgically treated patients. The type of surgery had no impact, but the occurrence of pouchitis, namely, in a chronic form, was associated with a lower HRQoL. Regression analysis confirmed surgery as an independent predictor of lower scores in the social dimension of the IBDQ (-4.646, 95% CI-6.953 to-2.339) and in the physical functioning (-9.622, 95% CI-17.061 to-2.183) and physical role functioning (-3.669, 95% CI-7.339 to 0.001) dimensions of the SF36. Conclusions: Although usually feared by patients, surgery has a limited impact on UC patients HRQoL when compared to medical management with immunomodulatory drugs.

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Long-term quality of life after ileal pouch anal restorative proctocolectomy for ulcerative colitis

Cited by 8 publications

References 9 publications

Quality of Life in Patients with Acute Severe Ulcerative Colitis: Long-Term Follow-Up Results from the CONSTRUCT Trial

Quality of Life in Patients with Acute Severe Ulcerative Colitis: Long-Term Follow-Up Results from the CONSTRUCT Trial

A systematic review and meta‐analysis of outcomes after elective surgery for ulcerative colitis

Health-Related Quality of Life in Patients with Moderate to Severe Ulcerative Colitis: Surgical Intervention versus Immunomodulatory Therapy

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