1. Quality of Life after Colectomy due to Ulcerative Colitis Katrín Guðlaugsdóttir1, Tryggvi Björn Stefánsson1, Elsa Björk Valsdóttir1,2  1 Depratment of General Surgery, Landspitai University Hospital, 2Faculty of Medicine, University of Iceland
Introduction
Surgery is an important part of the treatment of Ulcerative Colitis (UC). Approximately 25% of patients with UC require colectomy. Three types of procedures are offered: End-ileostomy, Ileo-anal pouch anastomosis and ileorectal anastomosis.
Purpose
The aim of this study was to assess the quality of life of these patients.
Material and Methods
All patients with UC who underwent colectomy in Iceland were included patients recieved three questionnaires. SF-36v2 and EORTC are standardised QOL-questionnaires addressing attitude towards health and rectoanal/stoma symptoms respectively. The third contained functional questions designed by the researchers.
Results
Eighty-three patients replied (78%), 45 male (54%) and 38 female (46%). Average age at operation was 45 years (range: 10-91). Fourty-four had ileostomy (53%), 28 had IPAA (34%) and 11 had IRA (13%).
Figure 2: Among patients who had colectomy 37% described post-operative changes in urinary habits and 46% in sexual life.
Figure 3: 76% of patients with IPAA admitted to faecal incontinence but the intontinence was mild according to the Wexner score in 83% of the cases.
Figure 4: According to SF-36 the QOL of colectomy patients is
slightly worse than among the general population. The difference is not statistically significant.
Figure 5: When subgroups are assessed there is not much difference in QOL between the groups.
Figure 6: Women have lower physical QOL (physical health score) but it is not statistically significant. There is no gender difference in mental QOL (mental health score).
Patients scored low on the symptom scales of the EORTC questionnaire, indicating mild symptoms. There is no significant difference between patients with or without stoma.
Conclusion
Urinary habits and sexual life is commonly affected after rectal removal, likely due to nerve injury. Faecal incontinence among IPAA-patients is much more common than expected but it is mild in most cases. There is not much difference in quality of life compared to the general population. Interestingly QOL does not always reflect the number of, or severity of complications. There is not much difference in the burden of symptoms between those with a stoma and those without. The results of the study are important for patient information in regards
to the choice of treatment options and what to expect post operatively 23 25 34 40 4 6 8 15 17 3