Polese Lino, Bressan Alice, Savarino Edoardo, Vecchiato Massimo, Turoldo Angelo, Frigo Annachiara, Sturniolo Giacomo Carlo, De Manzini Nicolò, Petri Roberto, Merigliano Stefano
Department of Surgery, Oncology and Gastroenterology, Padova University, Padova, Italy.
Clinica Chirurgica 3^, Policlinico Universitario, sesto piano. Via Giustiniani 2, 35128, Padova, Italy.
Int J Colorectal Dis. 2018 May;33(5):513-523. doi: 10.1007/s00384-018-3005-y. Epub 2018 Mar 10.
The study aimed to evaluate the QoL in patients who underwent elective surgery for uncomplicated diverticulitis using a recently developed diverticulitis quality of life questionnaire (DV-QoL).
All consecutive patients who underwent surgery for uncomplicated diverticulitis or who were hospitalized and treated conservatively for acute uncomplicated diverticulitis episodes in three referral centers, in a 5-year period, were included in the study. The 36-Item Short Form Survey and the DV-QoL were administered to the patients to assess their QoL before and after treatment of diverticular disease.
Ninety-seven patients who underwent surgery, 44 patients who were treated conservatively, and 44 healthy volunteers were included in the study. DV-QoL scores correlated with SF-36 scores (p < 0.0001). The surgically treated patients reported a worse quality of life before treatment with respect to the patients treated conservatively (mean 21.12 surgical vs 15.41 conservative, p = 0.0048). The surgically treated patients presented better post-treatment global scores with respect to the conservatively treated patients (mean: 6.90 surgical vs 10.61 conservative, p = 0.0186). Covariance analysis confirmed that the differences between the pre- and post-treatment DV-QoL scores were significantly higher in the surgical (p = 0.0002) with respect to the non-surgical patients. As far as single items were concerned, differences between the two groups were found in the pre- and post-treatment "concerns" and "behavioral changes" DV-QoL items.
Sigmoidectomy reduces concerns about diverticulitis and behavioral changes due to the disease. Quality of life should be considered when referring patients with uncomplicated diverticulitis to surgery. Prospective studies are required to confirm this result.
本研究旨在使用最近开发的憩室炎生活质量问卷(DV-QoL)评估因非复杂性憩室炎接受择期手术患者的生活质量。
在5年期间,纳入了在三个转诊中心因非复杂性憩室炎接受手术或因急性非复杂性憩室炎发作住院并接受保守治疗的所有连续患者。向患者发放36项简短调查问卷和DV-QoL,以评估憩室疾病治疗前后他们的生活质量。
97例接受手术的患者、44例接受保守治疗的患者和44名健康志愿者纳入本研究。DV-QoL评分与SF-36评分相关(p<0.0001)。与接受保守治疗的患者相比,接受手术治疗的患者在治疗前报告的生活质量较差(手术组平均为21.12,保守组为15.41,p = 0.0048)。与接受保守治疗的患者相比,接受手术治疗的患者治疗后的总体评分更高(平均:手术组为6.90,保守组为10.61,p = 0.0186)。协方差分析证实,手术患者治疗前后DV-QoL评分的差异显著高于非手术患者(p = 0.0002)。就单个项目而言,两组在治疗前后的“担忧”和“行为改变”DV-QoL项目中存在差异。
乙状结肠切除术减少了对憩室炎的担忧以及该疾病引起的行为改变。将非复杂性憩室炎患者转诊手术时应考虑生活质量。需要前瞻性研究来证实这一结果。