Colectomy and health-related Quality of Life in children with ulcerative colitis

BACKGROUND: Restorative proctocolectomy and ileal pouch -anal anastomosis (IPAA) is the recommended elective surgery for children with ulcerative colitis (UC). The aim of this study was to evaluate functional and long-term health-related Quality of Life (HRQoL) outcomes of surgery in pediatric patients with UC. METHODS: We reviewed the hospital records of all pediatric patients who had undergone surgery for UC between January 2009 and December 2016 in the Units of Pediatric Gastroenterology and Surgery, of both the University Hospital of Messina, and the Gaslini Children's Hospital of Genoa. Surgical treatment was represented by restorative proctocolectomy and laparoscopic IPAA. Patients and parents were interviewed by telephone before and after surgery and responded to the modified IMPACT III questionnaire about health outcomes and HRQoL. The questionnaire was scored on a five-point scale with higher scores indicating a better HRQoL. The total score ranged from 35 (worst HRQoL) to 175 (best HRQoL). RESULTS: Data were obtained in 30 patients (16 males), with a median age of 12 (range 3-16). The median amount of time elapsed after the operation was 3 years (range 1-4.5). Preoperative scores were very low in all 4 domains of the questionnaire. Postoperatively, HRQoL measures improved significantly (P<0.05) on symptoms, school attendance, social activities, and emotional aspects. Overall, nearly all were completely satisfied with the outcome of surgery. CONCLUSIONS: Our data confirmed that surgical treatment improves the overall HRQoL in pediatric patients with UC.