Early postoperative complications have long-term impact on quality of life after restorative proctocolectomy
- Resource Type
- Authors
- Jonathan Williman; Yun Lee; Andrew McCombie; Emma McKay; Richard B. Gearry; Frank A. Frizelle; Tim Eglinton; Rutvik Vanamala
- Source
- Medicine
- Subject
- Male
medicine.medical_specialty
Time Factors
complications
Cross-sectional study
medicine.medical_treatment
ileal pouch-anal anastomosis
Observational Study
Anastomosis
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Quality of life
medicine
Humans
In patient
Retrospective Studies
Proctocolectomy
business.industry
General surgery
Proctocolectomy, Restorative
Retrospective cohort study
General Medicine
restorative proctocolectomy
Middle Aged
Term (time)
Cross-Sectional Studies
quality of life
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
Self Report
business
Cohort study
Research Article
- Language
- ISSN
- 1536-5964
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.