TY - JOUR
T1 - Quality of life and colorectal function in Crohn’s disease patients that underwent ileocecal resection during childhood
AU - Diederen, Kay
AU - de Ridder, Lissy
AU - van Rheenen, Patrick
AU - Wolters, Victorien M.
AU - Mearin, Maria L.
AU - de Meij, Tim G.
AU - van Wering, Herbert
AU - Oomen, Matthijs W.
AU - de Jong, Justin R.
AU - Sloots, Cornelius E.
AU - Benninga, Marc A.
AU - Kindermann, Angelika
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Psychosocial and functional outcomes after intestinal resection in pediatric Crohn’s disease (CD) are lacking. Therefore, we (I) assessed health-related quality of life (HRQOL), colorectal function, and satisfaction with surgery and (II) investigated their relationship with surgical outcomes, after ileocecal resection for CD. Crohn’s patients that underwent ileocecal resection during childhood were included. HRQOL and colorectal function were assessed using SF-36 and COREFO, respectively, and compared with reference values. Satisfaction was scored on a 5-point Likert scale. In total, 80 patients (50% male, median age 23.0 years) were included. Physical HRQOL was impaired (SF-36 [mean]: CD, 47 vs. general, 54; p < 0.001), while mental HRQOL was similar to that in the general population. Overall colorectal function was impaired (COREFO [mean]: CD, 12.6 vs. normal, 7.2; p < 0.001). Worse colorectal function was associated with increasing clinical disease activity and longer interval since resection. Majority of patients was satisfied with surgery (81% satisfied/very satisfied, 11% neither satisfied nor dissatisfied, 8% dissatisfied/very dissatisfied). Decreased satisfaction with surgery was associated with increased clinical disease activity but not related to colorectal function. Conclusions: Physical HRQOL and colorectal function in CD patients who underwent ileocecal resection during childhood seem impaired and related to adverse surgical outcomes. This emphasizes the need for post-operative monitoring and prophylactic therapies.What is Known:• Up to 25% of pediatric-onset Crohn’s disease (CD) patients undergo an intestinal resection within 5 years from diagnosis.• Many children and adults with CD experience disruption of their daily activities and health-related quality of life (HRQOL).What is New:• Physical HRQOL and colorectal function are impaired in patient with CD that underwent ileocecal resection during childhood.• Increasing clinical disease activity, a longer interval since surgery, severe complications related to surgery, and recurrent surgeries are all associated with worse colorectal function.
AB - Psychosocial and functional outcomes after intestinal resection in pediatric Crohn’s disease (CD) are lacking. Therefore, we (I) assessed health-related quality of life (HRQOL), colorectal function, and satisfaction with surgery and (II) investigated their relationship with surgical outcomes, after ileocecal resection for CD. Crohn’s patients that underwent ileocecal resection during childhood were included. HRQOL and colorectal function were assessed using SF-36 and COREFO, respectively, and compared with reference values. Satisfaction was scored on a 5-point Likert scale. In total, 80 patients (50% male, median age 23.0 years) were included. Physical HRQOL was impaired (SF-36 [mean]: CD, 47 vs. general, 54; p < 0.001), while mental HRQOL was similar to that in the general population. Overall colorectal function was impaired (COREFO [mean]: CD, 12.6 vs. normal, 7.2; p < 0.001). Worse colorectal function was associated with increasing clinical disease activity and longer interval since resection. Majority of patients was satisfied with surgery (81% satisfied/very satisfied, 11% neither satisfied nor dissatisfied, 8% dissatisfied/very dissatisfied). Decreased satisfaction with surgery was associated with increased clinical disease activity but not related to colorectal function. Conclusions: Physical HRQOL and colorectal function in CD patients who underwent ileocecal resection during childhood seem impaired and related to adverse surgical outcomes. This emphasizes the need for post-operative monitoring and prophylactic therapies.What is Known:• Up to 25% of pediatric-onset Crohn’s disease (CD) patients undergo an intestinal resection within 5 years from diagnosis.• Many children and adults with CD experience disruption of their daily activities and health-related quality of life (HRQOL).What is New:• Physical HRQOL and colorectal function are impaired in patient with CD that underwent ileocecal resection during childhood.• Increasing clinical disease activity, a longer interval since surgery, severe complications related to surgery, and recurrent surgeries are all associated with worse colorectal function.
KW - Colorectal function
KW - Crohn’s disease
KW - Intestinal resection
KW - Pediatric
KW - Quality of life
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85069455940&partnerID=8YFLogxK
U2 - 10.1007/s00431-019-03427-3
DO - 10.1007/s00431-019-03427-3
M3 - Article
C2 - 31327075
AN - SCOPUS:85069455940
SN - 0340-6199
VL - 178
SP - 1413
EP - 1421
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
IS - 9
ER -