Mo1622 The Presence of Abdominal Hernia Is Associated With Adverse Outcomes of the Ileal Pouch

Abstract

abdominal surgery results in increased operative time and a longer and more complicated convalescence. Although a clear association between adhesiolysis, intraoperative adverse events and postoperative morbidity has been established, the impact of adhesiolysis on PROs after abdominal surgery has never been investigated. Aim To assess the impact of adhesiolysis and adhesiolysis-related complications on quality of life 6 months after surgery in patients undergoing elective abdominal surgery. Methods Design Prospective cohort study, before surgery and six months after discharge patients were asked to complete the SF-36 questionnaire. Univariable and multivariable linear regression analyses were used to assess the impact of patient factors on the total score of the SF-36. Settings Tertiary referral university medical center Participants Patients participating in the LAPAD study, undergoing elective abdominal surgery Results 518 (78%) out of 662 patients completed preand postoperative questionnaires. 319 (62%) patients required adhesiolysis during surgery. Overall preand postoperative quality of life did not significantly differ between patients requiring or not requiring adhesiolysis. (figure 1). Postoperatively, only physical functioning was significantly lower for patients requiring adhesiolysis (p 0.01). In the multivariable analysis, chronic abdominal pain (B -0.14; p <0.01), postoperative Clavien-Dindo grade 4 complications (B -0.15; p <0.01), concomitant pulmonary disease (B -0.06; p 0.04), age (-0.00; p 0.04) and readmissions within and after 30 days (B -0.06; p 0.01 and B -0.07; p <0.01) decreased quality of life 6 months after surgery the most (table 1). A higher preoperative SF-36 score (B 0.44; p <0.01) positively impacted quality of life after surgery. Conclusion Chronic abdominal pain and Clavien-Dindo grade 4 complications have a large negative impact on postoperative quality of life 6 months after surgery for patients undergoing elective abdominal surgery. Additionally, age, concomitant pulmonary disease and readmissions also show to negatively impact the quality of life of patients. Higher preoperative quality of life showed to be an independent protective factor for postoperative quality of life. The need for adhesiolysis during abdominal surgery does not directly impair quality of life of patients 6 months after surgery. These results can be used for improving patient counseling. Table 1 Multivariable linear regression analysis for patient factors impacting the SF-36 score 6 months after surgery