BACKGROUND: The effect of surgery on quality of life (QOL) in the early postoperative period is important in Crohn's disease because of the multiple surgical procedures that patients undergo and the acute QOL benefits that might occur as a result of modifications of medical treatment. Earlier studies of the effect of surgery on QOL have been retrospective and assessed changes 3 to 24 months after surgery. This study prospectively assesses the effect of surgery on QOL in the early postoperative period. STUDY DESIGN: Patients requiring surgical management of sequelae of Crohn's disease were obtained from a prospectively entered database including data on QOL. Preoperative and 30-day postoperative QOL were determined in 82 patients using Cleveland Global Quality of Life (CGQL) scores (range from 0 [worst] to 10 [best possible] QOL). Preoperative and postoperative scores were compared using a paired t-test to determine the significance of any change in QOL after surgery. The effect of other variables on change in QOL after surgery was assessed using the t-test or analysis of variance. Multifactor analysis of variance was used to assess the effect of several independent variables. RESULTS: Eighty-two patients (41 women) of 142 patients who had had surgery (58%) had complete preoperative and 30-day postoperative scores. The incidence of complications was 23% (11% were major). There was a significant improvement in QOL 30 days after surgery as measured by CGQL (0.6 +/- 0.2 preoperative to 0.7 +/- 0.2 postoperative; mean +/- SD; p < 0.001). The mean preoperative CGQL was 0.56 +/- 0.24 and the mean improvement was 0.11 +/- 0.20 toward a better QOL. Female patients (p < 0.05) and those who did not develop complications within 30 days of surgery (p < 0.05) had a significantly greater improvement in CGQL after surgery than other groups. No other factor was predictive of improved outcomes. CONCLUSIONS: QOL as measured by CGQL improves early after surgery (30 days postoperatively). Improvement in CGQL is greater in female patients and patients who do not develop complications in the postoperative period. It is not affected by other patient characteristics, nature of disease, indication, or procedure performed. Most patients who undergo surgery for Crohn's disease feel that surgery has helped them and would undergo surgery again.
BACKGROUND: The effect of surgery on quality of life (QOL) in the early postoperative period is important in Crohn's disease because of the multiple surgical procedures that patients undergo and the acute QOL benefits that might occur as a result of modifications of medical treatment. Earlier studies of the effect of surgery on QOL have been retrospective and assessed changes 3 to 24 months after surgery. This study prospectively assesses the effect of surgery on QOL in the early postoperative period. STUDY DESIGN:Patients requiring surgical management of sequelae of Crohn's disease were obtained from a prospectively entered database including data on QOL. Preoperative and 30-day postoperative QOL were determined in 82 patients using Cleveland Global Quality of Life (CGQL) scores (range from 0 [worst] to 10 [best possible] QOL). Preoperative and postoperative scores were compared using a paired t-test to determine the significance of any change in QOL after surgery. The effect of other variables on change in QOL after surgery was assessed using the t-test or analysis of variance. Multifactor analysis of variance was used to assess the effect of several independent variables. RESULTS: Eighty-two patients (41 women) of 142 patients who had had surgery (58%) had complete preoperative and 30-day postoperative scores. The incidence of complications was 23% (11% were major). There was a significant improvement in QOL 30 days after surgery as measured by CGQL (0.6 +/- 0.2 preoperative to 0.7 +/- 0.2 postoperative; mean +/- SD; p < 0.001). The mean preoperative CGQL was 0.56 +/- 0.24 and the mean improvement was 0.11 +/- 0.20 toward a better QOL. Female patients (p < 0.05) and those who did not develop complications within 30 days of surgery (p < 0.05) had a significantly greater improvement in CGQL after surgery than other groups. No other factor was predictive of improved outcomes. CONCLUSIONS: QOL as measured by CGQL improves early after surgery (30 days postoperatively). Improvement in CGQL is greater in female patients and patients who do not develop complications in the postoperative period. It is not affected by other patient characteristics, nature of disease, indication, or procedure performed. Most patients who undergo surgery for Crohn's disease feel that surgery has helped them and would undergo surgery again.
Authors: Stefan Maartense; Mich S Dunker; J Frederik M Slors; Miguel A Cuesta; Erik G J M Pierik; Dirk J Gouma; Daan W Hommes; Miriam A Sprangers; Willem A Bemelman Journal: Ann Surg Date: 2006-02 Impact factor: 12.969
Authors: Michael S Kasparek; Joerg Glatzle; Mario H Mueller; Andreas Schneider; Alfred Koenigsrainer; Martin E Kreis Journal: J Gastrointest Surg Date: 2007-11-28 Impact factor: 3.452
Authors: S Riss; K Schwameis; M Mittlböck; M Pones; H Vogelsang; W Reinisch; M Riedl; A Stift Journal: Tech Coloproctol Date: 2012-09-06 Impact factor: 3.781
Authors: Emma J Eshuis; Willem A Bemelman; Ad A van Bodegraven; Mirjam A G Sprangers; Patrick M M Bossuyt; A W Marc van Milligen de Wit; Rogier M P H Crolla; Djuna L Cahen; Liekele E Oostenbrug; Meindert N Sosef; Annet M C J Voorburg; Paul H P Davids; C Janneke van der Woude; Johan Lange; Rosalie C Mallant; Maarten J Boom; Rob J Lieverse; Edwin S van der Zaag; Martin H M G Houben; Juda Vecht; Robert E G J M Pierik; Theo J M van Ditzhuijsen; Hubert A Prins; Willem A Marsman; Henricus B Stockmann; Menno A Brink; Esther C J Consten; Sjoerd D J van der Werf; Andreas W K S Marinelli; Jeroen M Jansen; Michael F Gerhards; Clemens J M Bolwerk; Laurents P S Stassen; B W Marcel Spanier; Ernst Jan Spillenaar Bilgen; Anne-Marie van Berkel; Huib A Cense; Henk A van Heukelem; Arnold van de Laar; Warner Bruins Slot; Quirijn A Eijsbouts; Nancy A M van Ooteghem; Bart van Wagensveld; Jan M H van den Brande; Anna A W van Geloven; Karien F Bruin; John K Maring; Bas Oldenburg; Richard van Hillegersberg; Dirk J de Jong; Robert Bleichrodt; Donald L van der Peet; Pascal E P Dekkers; T Hauwy Goei; Pieter C F Stokkers Journal: BMC Surg Date: 2008-08-22 Impact factor: 2.102