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溃疡性结肠炎患儿结肠切除和回肠直肠吻合术后的生活质量。

Quality of life after colectomy and ileo-jpouch-anal anastomosis in paediatric patients with ulcerative colitis.

机构信息

Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Largo Gaslini 5, 16147, Genoa, Italy.

DINOGMI, University of Genoa, Genoa, Italy.

出版信息

Pediatr Surg Int. 2024 Aug 17;40(1):231. doi: 10.1007/s00383-024-05824-8.

Abstract

INTRODUCTION

Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD). Surgery is required in cases of severe acute colitis, massive hemorrhage, toxic megacolon, and perforation; in such cases colectomy and JpouchIleoanal anastomosis (IPAA) are performed. The aim of this study was to evaluate functional outcome, and patient satisfaction and Quality of Life (QoL) after surgery.

MATERIAL AND METHODS

Questionnaires were administered to 24 patients with UC undergoing surgery from 2011 to 2022.

RESULTS

Mean age at IPAA was 10.8 years. Twenty patients underwent IPAA in 3 operations, 4 patients in 2. All patients underwent laparoscopic surgery. 6 months after surgery mean level of satisfaction was 8.7/10, perception of health status was 7.4. Twenty-three patients (95.8%) recommended IPAA. For 20 patients (83.3%) surgery did not cause delay in education, while 14 patients (58.3%) played sport. The lowest number of evacuations was 9.2 per day, the highest 13.3. Seventeen patients (70.8%) had no incontinence and 15 patients (62.5%) were not affected by pouchitis. After 12 months mean satisfaction level raised up to 9.2/10, perception of health status to 8.5. School absences decreased and no other patients showed any delay in education. Seventeen (70.8%) patients played sports. The number of evacuations decreased: the lowest number was 5.1 per day, the highest 7.5. Twenty patients (83.3%) were continent and 12 (50%) did not use antibiotics.

CONCLUSION

Most patients show a good functional outcome in defecation frequency and continence, which has improved through time, number of pouchitis episodes has increased. Patients appear satisfied after surgery.

摘要

介绍

溃疡性结肠炎(UC)是一种炎症性肠病(IBD)。在严重急性结肠炎、大量出血、中毒性巨结肠和穿孔的情况下需要手术;在这种情况下,进行结肠切除术和 J 袋回肠肛门吻合术(IPAA)。本研究旨在评估手术后的功能结果、患者满意度和生活质量(QoL)。

材料和方法

对 2011 年至 2022 年期间接受手术的 24 例 UC 患者进行问卷调查。

结果

IPAA 的平均年龄为 10.8 岁。20 例患者行 3 次 IPAA 手术,4 例患者行 2 次。所有患者均行腹腔镜手术。术后 6 个月,平均满意度为 8.7/10,健康状况感知为 7.4。23 例患者(95.8%)推荐 IPAA。对于 20 名患者(83.3%),手术不会导致教育延误,而 14 名患者(58.3%)参加运动。排便次数最少为每天 9.2 次,最多为 13.3 次。17 例患者(70.8%)无失禁,15 例患者(62.5%)不受 pouchitis 影响。术后 12 个月,满意度平均提高至 9.2/10,健康状况感知提高至 8.5。缺课减少,无其他患者出现教育延误。17 名患者(70.8%)参加运动。排便次数减少:最低为每天 5.1 次,最高为每天 7.5 次。20 名患者(83.3%)有节制,12 名患者(50%)不使用抗生素。

结论

大多数患者在排便频率和节制方面表现出良好的功能结果,并且随着时间的推移有所改善, pouchitis 发作次数增加。手术后患者满意度高。

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