Kvalita života u pacientů s Crohnovou chorobou po střevní resekci – první výsledky

English version

Autoři: L. Kunovsky ¹; Z. Kala ¹; L. Mitas ¹; J. Dolina ²; V. Can ¹; L. Kucerova ²; V. Jadczakova ³; I. Penka ¹
Působiště autorů: Department of Surgery, University Hospital Brno Bohunice, Faculty of Medicine, Masaryk University Head of Department: prof. Z. Kala, M. D., Ph. D. ¹; Department of Gastroenterology, University Hospital Brno Bohunice, Faculty of Medicine, Masaryk University Head of Department: prof. A. Hep, M. D., Ph. D. ²; Department of Applied Statistics and Demography, Faculty of International Development and International Studies Mendel University in Brno Head of Department: assoc. prof. Ing. K. Somerlikova, Ph. D. ³
Vyšlo v časopise: Rozhl. Chir., 2016, roč. 95, č. 12, s. 444-448.
Kategorie: Původní práce

Souhrn

Úvod:
Crohnova choroba značně ovlivňuje kvalitu života u pacientů trpících touto chorobou. Cílem naší studie bylo zjistit, jaký vliv má chirurgické řešení na kvalitu života u pacientů s Crohnovou chorobou a určit faktory, které pooperační kvalitu života ovlivňují.

Metody:
90 pacientů s Crohnovou chorobou, kteří na našem pracovišti podstoupili resekci střeva, vyplnili v předoperačním a pooperačním období dotazník kvality života EORTC QLQ-CR29.

Výsledky:
U 77 % pacientů bylo zjištěno zlepšení kvality života (p<0.001), u 22 % pacientů zhoršení a u 11 % pacientů nebyla zjištěna změna.

Závěr:
V našem souboru operovaných pacientů s Crohnovou chorobou jsme prokázali, že chirurgická léčba zvyšuje jejich celkovou kvalitu života. K určení faktorů, které ovlivňují pooperační kvalitu života, je zapotřebí soubor s větším počtem pacientů.

Klíčová slova:
Crohnova choroba – kvalita života – chirurgie – resekce střeva – česká kohorta

Zdroje

1. Mikocka-Walus AA, Turnbull DA, Andrews JM, et al. Psychological problems in gastroenterology outpatients: A South Australian experience. Psychological co-morbidity in IBD, IBS and hepatitis C. Clin Pract Epidemiol Ment Health 2008;4:15.

2. Gavrilescu O, Mihai C, Anton-Paduraru DT, et al. Impact of inflammatory bowel diseases on quality of life. Revista de Cercetare si Interventie Sociala 2015;50:80–95.

3. Lix L, Graff L, Walker J, et al. Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease. Inflamm Bowel Dis 2008;14:1575–84.

4. Casellas F, López-Vivancos J, Badia X, et al. Impact of surgery for Crohn’s disease on health-related quality of life. Am J Gastroenterol 2000;95:177–82.

5. Julsgaard M, Nørgaard M, Hvas CL, et al. Influence of medical treatment, smoking and disease activity on pregnancy outcomes in Crohn’s disease. Scand J Gastroenterol 2014;49:302–8.

6. Pedersen N, Munkholm P, Bortoli A, et al. The course of inflammatory bowel disease during pregnancy and postpartum: A prospective European ECCO-EpiCom Study of 209 pregnant women. Aliment Pharmacol Ther 2013;38:501–12.

7. Nørgård B, Hundborg H, Jacobsen B, et al. Disease activity in pregnant women with crohn’s disease and birth outcomes: A regional Danish cohort study. Am J Gastroenterol 2007;102:1947–54.

8. Nørgård BM, Nielsen J, Fonager K, et al. The incidence of ulcerative colitis (1995–2011) and Crohn’s disease (1995−2012) − Based on nationwide Danish registry data. J Crohns Colitis 2014;8:1274–80.

9. Wilson J, Bell S, Kamm M, et al. High incidence of inflammatory bowel disease in Australia: A prospective population-based Australian incidence study. Inflamm Bowel Dis 2010;16:1550–6.

10. Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012;142:46–54.e42.

11. Kunovsky L, Hemmelova B, Kala Z, et al. Crohn disease and pregnancy: a case report of an acute abdomen. Int J Colorectal Dis 2016;31:1493–4.

12. Vegh Z, Burisch J, Pedersen N, et al. Incidence and initial disease course of inflammatory bowel diseases in 2011 in Europe and Australia: Results of the 2011 ECCO-EpiCom inception cohort. J Crohns Colitis 2014;8:1506–15.

13. Lowe A-M, Roy P-O, Poulin M-B, et al. Epidemiology of Crohn's disease in QuéBec, Canada. Inflamm Bowel Dis 2009;15:429–35.

14. Aratari A, Papi C, Leandro G, et al. Early versus late surgery for ileo-caecal Crohn’s disease. Aliment Pharmacol Ther 2007;26:1303–12.

15. De Cruz P, Kamm MA, Hamilton AL, et al. Crohn’s disease management after intestinal resection: a randomised trial. The Lancet 2015;385:1406–17.

16. Bernell O, Lapidus A, Hellers G. Risk factors for surgery and postoperative recurrence in Crohn’s disease. Ann Surg 2000;231:38–45.

17. Bobanga I, Bai S, Swanson M, et al. Factors influencing disease recurrence after ileocolic resection in adult and pediatric onset Crohn’s disease. Am J Surg 2014;208:591–6.

18. Fornaro R, Caratto E, Caratto M, et al. Post-operative recurrence in Crohn’s disease. Critical analysis of potential risk factors. An update. The Surgeon 2015;13:330–47.

19. Guyatt G, Mitchell A, Irvine EJ, et al. A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology 1989;96:804–10.

20. Aaronson N, Ahinedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365–76.

21. Whistance RN, Conroy T, Chie W, et al. Clinical and psychometric validation of the EORTC QLQ-CR29 questionnaire module to assess health-related quality of life in patients with colorectal cancer. Eur J Cancer 2009;45:3017–26.

22. Gujral S, Conroy T, Fleissner C, et al. Assessing quality of life in patients with colorectal cancer: An update of the EORTC quality of life questionnaire. Eur J Cancer 2007;43:1564–73.

23. Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006;55:749–53.

24. Delaney CP, Kiran RP, Senagore AJ, et al. Quality of life improves within 30 days of surgery for Crohn’s disease. J Am Coll Surg 2003;196:714–21.

25. Achkar JP, Hanauer SB. Medical therapy to reduce postoperative Crohn’s disease recurrence. Am J Gastroenterol 2000;95:1139–46.

26. Tabibian A, Tabibian JH, Beckman LJ, et al. Predictors of health-related quality of life and adherence in Crohn’s disease and ulcerative colitis: implications for clinical management. Dig Dis Sci 2015;60:1366–74.

27. Scarpa M, Ruffolo C, Bassi D, et al. Intestinal surgery for Crohn’s disease: Predictors of recovery, quality of life, and costs. J Gastrointest Surg 2009;13:2128−35.