QUALITY-OF-LIFE ASSESSMENT IN ABDOMINAL-SURGERY - ILEOSTOMY SURGERY

Although total proctocolectomy and conventional ileostomy is the standard operation for patients requiring surgery for ulcerative colitis, there are three other options which have been championed because of their improved quality of life: colectomy and ileorectal anastomosis, Kock continent ileostomy and ileal reservoir, and ileoanal anastomosis. Various surveys have documented a high quality of life following all procedures. The usefulness of these results is limited, however, in that quality of life has not been measured quantitatively. Thus, results following the various procedures cannot be compared, and they are not amenable to statistical testing. Two instruments - the Time Trade-Off Technique (TTOT) and the Direct Questioning of Objectives (DQO) - have been shown to be valid in assessing quality of life in these patients. However, further efforts in this area should be directed toward the development of disease- or procedure-specific instruments. These would be valuable in comparing quality of life following the different procedures as well as in evaluating outcome following modifications in surgical technique. This information would assist in clinical decision making as well as in patient education.