Aarhus University Hospital, Aarhus, Denmark.
Colorectal Dis. 2013 Aug;15(8):e453-61. doi: 10.1111/codi.12270.
The study evaluated function and quality of life (QoL) in all patients having restorative proctocolectomy (RPC) in Denmark for ulcerative colitis (UC) from 1980 to 2010. Inclusion of all patients in one country has never previously been achieved.
All patients who had had a RPC in Denmark, from the first case in 1980 to the last case in 2010, were studied. A cross-sectional questionnaire survey was performed, and function and QoL were assessed using a standardized questionnaire - the Short-Form 36 (SF36) - and the inflammatory bowel disease questionnaire (IBDQ).
The median duration of follow up was 11 (range, 1-30) years. Apart from deaths, pouch failures and research protection, data on function and QoL were obtained from 1047 (85%) of 1229 patients who had a functioning pouch at the time of the investigation. More female patients than male patients experienced urgency (56% vs 44%, P = 0.0021). The median number of bowel movements per 24 h was 7 (range, 1-23) in female patients and 6 (range, 1-20) in male patients (P < 0.001). Pad usage was more frequent among female patients than among male patients (62% vs 38%, P < 0.001). A higher incidence of major incontinence (P = 0.009) and use of pads (P = 0.01) was found among patients who had been operated on 21-30 years previously compared with those operated on 11-20 years previously. The prevalence of urgency was higher in patients who received surgery 0-10 years previously compared with 11-20 years previously (P = 0.009). The total IBDQ score was higher in male patients than in female patients (P < 0.001). Male patients scored higher in five of eight SF36 domains (P < 0.001).
Female patients had more urgency, a higher frequency of defaecation and higher pad usage. This was associated with a reduced QoL. Nevertheless, RPC resulted in good function and a high degree of satisfaction in most patients.
本研究评估了 1980 年至 2010 年丹麦所有接受溃疡性结肠炎直肠结肠切除术（RPC）的患者的功能和生活质量（QoL）。此前，从未在一个国家完成对所有患者的纳入。
研究纳入了丹麦所有接受 RPC 的患者，包括首例病例（1980 年）至最后一例病例（2010 年）。进行了一项横断面问卷调查，使用标准化问卷——36 项简短健康调查问卷（SF36）和炎症性肠病问卷（IBDQ）评估功能和 QoL。
中位随访时间为 11 年（范围 1-30 年）。除死亡、造口失败和研究保护外，在接受调查时具有功能造口的 1229 名患者中，有 1047 名（85%）患者获得了功能和 QoL 数据。女性患者比男性患者更常经历急迫感（56%比 44%，P = 0.0021）。女性患者 24 小时内排便次数中位数为 7 次（范围 1-23 次），男性患者为 6 次（范围 1-20 次）（P < 0.001）。女性患者比男性患者更常使用护垫（62%比 38%，P < 0.001）。与接受手术 11-20 年的患者相比，接受手术 21-30 年的患者更易出现严重失禁（P = 0.009）和使用护垫（P = 0.01）。与接受手术 11-20 年的患者相比，0-10 年前接受手术的患者急迫感发生率更高（P = 0.009）。男性患者的 IBDQ 总分高于女性患者（P < 0.001）。男性患者在 8 个 SF36 领域中的 5 个领域的评分均高于女性患者（P < 0.001）。
女性患者更易出现急迫感、排便频率更高、更常使用护垫。这与 QoL 降低有关。然而，RPC 为大多数患者带来了良好的功能和高度的满意度。
