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Early postoperative complications have long-term impact on quality of life after restorative proctocolectomy.

Abstract：

INTRODUCTION:Early postoperative complications graded according to the Clavien-Dindo classification system have not previously been correlated with long-term quality of life outcomes in patients who have had restorative proctocolectomy with ileal pouch-anal anastomosis. This study aimed to assess the severity of early postoperative complications and compared these in terms of the long-term quality of life after restorative proctocolectomy in a population-based cohort of patients (operated on from 1984 to 2013). It was hypothesized that those who experienced grade 3 or 4 Clavien-Dindo complications would have worse quality of life at follow-up. METHODS:This population-based study used a combination of a retrospective note review and a cross-sectional questionnaire. All patients with a restorative proctocolectomy performed in 1984-2013 in the Canterbury region were recruited using multiple sources. Early (≤30 days) and late (>30 days) complication rates were obtained via patient records. Early postoperative complications were graded according to the Clavien-Dindo classification. Quality of life was measured using the inflammatory bowel disease questionnaire. RESULTS:One hundred and thirty-six people were identified with a median follow-up of 12 years. Data were available for 121 patients for early complications and 112 for late complications. Eighty-one eligible participants had their quality of life assessed (86% response rate). Early complications occurred in 26% and 76% had late complications. Those who had Clavien-Dindo grade 3 or 4 early complications had lower quality of life scores (P = 0.001) as did females (P = 0.004) and those with a stricture (P = 0.031). CONCLUSION:This population-based study with long-term follow-up demonstrates that Clavien-Dindo grade 3 and 4 postoperative complications are important in determining quality of life in the long term. The reduction in these complications should be a focus of patient management, as it should improve long-term quality of life.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

McCombie A,Lee Y,Vanamala R,Gearry R,Frizelle F,McKay E,Williman J,Eglinton T

doi

10.1097/MD.0000000000003966

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

e3966

issue

eissn

0025-7974

issn

1536-5964

pii

00005792-201607050-00014

journal_volume

pub_type

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Early postoperative complications have long-term impact on quality of life after restorative proctocolectomy.