Exacerbations of ulcerative colitis (UC) have a great impact on patients' quality of life. Only a few data is available about the effect of surgery on the quality of life in patients with UC.
Aim: of our study was to evaluate the outcome and the impact of surgery on the quality of life of patients with UC.
Patients and methods: 183 UC patients [mean age at the diagnosis: 33.23 years (12-69 years), female/male ratio: 95/88] were hospitalized in our tertiary clinic because of exacerbation of UC requiring parenteral corticosteroid therapy between 1998 and 2007. Data of 46 patients undergoing colectomy were analyzed retrospectively. Outcome of surgery, frequency of early and late complications, the alteration of the number of hospitalizations and outpatient visits, the number of medication, the income and the disability grade were assessed in detail. The patients were also asked to complete questionnaires to compare their quality of life before and after colectomy. The follow up period was 3.3 years. Data were analyzed using two-sample t-test and one-way analysis of variance. P value lower than 0.05 was considered statistically significant.
Results: 74% of the colectomized patients underwent ileal pouch anal anastomosis procedure, 11 patients needed definitive ileostomy and in one case, ileorectal anastomosis was requested by the patient. Early complications occurred in 24, late complications in 23 patients (pouchitis in 13 cases). The need for hospitalization and the number of medication decreased significantly, while significant improvement was shown in the patients' quality of life after colectomy compared to the preoperative condition. Colectomy did not have an impact on the patients' income in 64.5% of the cases and no alteration of the disability grade was detected in 32% of the patients.
Discussion: Our results show that surgery may results in a good quality of life in the majority of the patients, however, further management may be necessary due to the late postoperative complications.