Abstract
Objective: Up to 30% of pediatric patients with Crohn's disease (CD) require surgery. The aim of the study was to evaluate long-term health-related quality of life (HRQoL) outcome in children with CD who have had ileocolonic resection.Materials and methods: This was a retrospective cross-sectional study on all pediatric patients who had undergone surgery for CD between January 2015 and December 2017 in the Pediatric Surgery and Gastroenterology Units of the University Hospital of Messina. Surgical treatment was represented by laparoscopic ileocecal resection with latero-lateral anastomosis. Patients were asked to fill in a modified version of the IMPACT III questionnaire made up of 15 closed questions before and after surgery. The questionnaire was scored on a five-point scale with 5 reporting “not a problem” and 1 “a very severe problem.” The total score ranged from 15 (worst HRQoL) to 75 (best HRQoL). Frequency of relapses, reoperations, complications during follow-up, and postoperative bowel function were also studied.Results: Data were obtained in 10 patients (9 males), who underwent surgery at a median age of 13.5 years (range 13–18), after a median post-diagnosis period of 2.5 years (range 0–8). Preoperative scores were low in all 4 domains of the questionnaire. Postoperatively, HRQoL measures improved significantly (p < 0.05) about symptoms, school attendance, social and emotional functioning. Overall, nearly all patients were completely satisfied with the surgical outcome.Conclusions: HRQoL is low in CD children referred for possible operation, and surgery may positively affect the overall HRQoL. Collecting HRQoL data provides insight into the impact of treatment on children health status.
Highlights
Crohn’s disease (CD) is a chronic, relapsing disease whose symptoms interfere with the daily activities of patients, especially in young patients who have a long life expectancy [1, 2]
The incidence of pediatric CD, in children 10–19 years of age, is increasing and the phenotype is often characterized by an aggressive disease course, higher risk of surgery, and more extensive phenotypes compared with adults [1, 3]
Numerous physical and psychological factors contribute to the poor health-related QoL (HRQoL) in pediatric patients with CD, such as its relatively young age of onset, associated extraintestinal complications, disability, and debilitating symptoms that have the potential to cause significant psychosocial stress [1, 6]
Summary
Crohn’s disease (CD) is a chronic, relapsing disease whose symptoms interfere with the daily activities of patients, especially in young patients who have a long life expectancy [1, 2]. The incidence of pediatric CD, in children 10–19 years of age, is increasing and the phenotype is often characterized by an aggressive disease course, higher risk of surgery (because of stenosis), and more extensive phenotypes compared with adults [1, 3]. Numerous physical and psychological factors contribute to the poor HRQoL in pediatric patients with CD, such as its relatively young age of onset, associated extraintestinal complications, disability, and debilitating symptoms (diarrhea, abdominal pain, gastrointestinal bleeding) that have the potential to cause significant psychosocial stress [1, 6]. The aim of the present study was to evaluate the long-term health outcomes of children with CD and undergone ileocolonic resection and to compare preoperative and postoperative HRQoL with a disease-specific questionnaire
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
