Patients with mild polyposis coli: long term quality of life after surgery vs. endoscopy
AbstractBackground: Patients with multiple colorectal adenomas (10 to 100 polyps) have a high risk of colorectal cancer. Treatments include: endoscopic management (EM, conservative treatment) and surgical treatment (SU): segmental colectomy or hemi-colectomy (SC, less invasive treatment) or total or subtotal colectomy (TC, more invasive treatment). The aim of this study is to assess the long-term quality of life (QoL) of these patients, comparing patients who underwent different treatments, and comparing them to the general population. Methods: Design: single-centre observational study. Participants: 34 patients with ≥10 years from diagnosis (endoscopy: n=10; segmental colectomy: n = 10; total colectomy: n=14). Measures: EORTC-QLQ C30, EORTC-QLQ CR29, MSKCC questionnaire for bowel functioning. Analyses: Non-parametric tests (Mann-Whitney U test, Kruskal-Wallis test, Chi squared) and clinical differences (≥10 points) for comparison with the general population on EORTC-QLQ C30 scores. Findings: EORTC-QLQ C30: Patients have more constipation (particularly EM and SC patients) and more diarrhoea (particularly TC patients) than the general population. TC patients have significantly more diarrhoea (p=.002) and less constipation (p=.051) than the both EM and SC patients. EORTC-QLQ CR29: TC patients have significantly higher stool frequency than other patients (p<.001). MSKCC: SU patients have worse total bowel function score than EM patients (p<.001), with TC patients exhibiting worse scores than SC patients (p<.001). The same pattern was found for the frequency, dietary and urgency/soilage scales. Discussion: The differences emerged in this study pertain mainly to patients’ bowel function and symptoms related to defecation issues, with scores correlated to the invasiveness of the treatment.
Copyright (c) 2017 T. Gavaruzzi, F. Giandomenico, A. Maritan, F. Celotto, E.D. Urso, I. Mammi, A. Perin, A. Barina, M. Zuin, L. Lotto
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