Health related quality of life in inflammatory bowel disease: The impact of surgical therapy

Table 1 Summary of included articles for health related quality of life in ulcerative colitis

Study	Patient population	HRQOL instruments	Study conclusions
Cohen et al[2]	Steroid-refractory UC patients treated with CSA vs colectomy	IBDQ visual-analog scale, Oresland	CSA patients had similar HRQOL compared to colectomy group. CSA can be alternative to surgery in selected patients
Sagar et al[13]	UC patients after IPAA vs UC patients on long-term medical treatment	based on a questionnaire by Oresland et al	HRQOL after IPAA is no worse than that of patients with long-standing UC on medical treatment in remission
Camilleri-Brennan et al[15]	UC patients with TPC and EI vs general population	SF-36 version 2 (SF-36II)	HRQOL of TPS and EI patients very similar to that of the general population. TPC and EI remains a viable option for patients with UC
da Luz Moreira et al[18]	UC patients with IRA vs IPAA	CGQL	HRQOL similar between groups, but IRA is inferior to IPAA because of dietary and work restrictions
Nessar et al[20]	CI (Kock) vs EI	CGQL	HRQOL significantly better with CI, but complications are common in CI group
Berndtsson et al[21]	UC patients before and after IPAA	GQL, VAS, OAS open ended questions	IPAA had no impact on HRQOL, but improved relations with friends, freedom in role function, and body image reduced the negative effects caused by colitis or life with ileostomy.
Michelassi et al[22]	10 yr prospective study of UC patients with IPAA	Two part questionnaire	Excellent long term functional outcomes after double stapled IPAA
Fazio et al[23]	UC patients with IPAA	SF 36 CGQL	HRQOL increase following IPAA; no deterioration with time.
Lian et al[25]	UC patients with hand sewn vs stapled IPAA complicated by anastomotic leak	CGQL	Functional outcomes following anastomotic leak better in stapled IPAA compared to handsewn IPAA
Scarpa et al[26]	UC patients, UC patients after IPAA, and normal controls	Italian CGQL vs PIBDQL	PIBDQL has significantly better discriminative ability compared to the Italian CGQL
Gearhart et al[27]	UC female patients with sphincter defects	FISI, FIQL Wexner score	IPAA can provide a satisfactory HRQOL in patients with sphincter defect who are fully continent preoperatively
Lepistö et al[28]	HRQOL after pouch failure vs well functioning IPAA	SF-36	IPAA failure group with significantly lower scores for physical function, energy level, and physical role function
Tan et al[29]	UC patients following pouch excision vs initial TPC and EI	SF-36	HRQOL similar between the pouch excision and initial IPAA groups
Baixauli et al[30]	IPAA patients with pouch failure	CGQL	CD is common cause of pouch failure. HRQOL similar in UC or CD pouch failure patients
Delaney et al[31]	IPAA patients 70 yr and older	CGQL	Good HRQOL, health, levels of energy and happiness. However, IPAA associated with high rate of morbidity and mortality
Lillehei et al[32]	Pediatric UC patients with IPAA	Standardized questionnaire	Excellent functional outcomes. High rate of pouchitis
Fichera et al[33]	Laparoscopic vs open IPAA	Two part questionnaire	HRQOL was similar between the groups. Better patient acceptance and improved cosmesis in laparoscopic IPAA
Larson et al[34]	Laparoscopic vs open IPAA	FSFI, IIEF body and cosmetic evaluation	HRQOL comparable between open and laparoscopic patients
Dunker et al[35]	Laparoscopic vs open IPAA	Body image questionnaire	HRQOL similar between groups
Davies et al[36]	Prospective evaluation of sexual function before and after IPAA	FSFI, IIEDF	Improved sexual function in women. Unchanged sexual function in men
Ording Olsen et al[38]	Reproductive health of women with UC undergoing IPAA vs UC vs general population		Significant decrease in fecundity (36% vs 80%-90%) following IPAA compared to UC and general population
Hahnloser et al[39]	Pregnancy following IPAA vs general population		No increase in pregnancy complications following IPAA. Vaginal delivery not contraindicated

HRQOL: Health related quality of life; UC: Ulcerative colitis; CSA: Cyclosporine A; VAS: Visual-analog scale; IPAA: Ileal pouch anal anastomosis; EI: End ileostomy; TPC: Total proctocolectomy; CGQOL: Cleveland Clinic Global Quality of Life; CI: Continent ileostomy; IRA: Ileorectal anastomosis; CGQL: Cleveland Global Quality of Life; PIBDQL: Padova Inflammatory Bowel Disease Quality of Life; GQL: General Quality-of-Life according to Kajang; FISI: Fecal Incontinence Severity Index; FIQL: Fecal Incontinence Quality of Life; IIEF: International index of erectile function.