Quality of life is excellent after a pelvic pouch for colitis-associated neoplasia

PURPOSE: Despite high patient satisfaction with a pelvic pouch, patients ex perience some bowel dysfunction. Patients whose indication for surgery is n eoplasia may have near-normal preoperative bowel function. We hypothesized that these patients would be less accepting of a poorer functional status a fter surgery, reflected in a poorer measure of quality of life. METHOD: Six teen patients who had dysplasia or cancer as the primary indication for sur gery were compared with a matched control group whose indication for surger y was failed medical therapy. Quality of life was assessed using one diseas e-specific instrument, the Inflammatory Bowel Disease Questionnaire, two ge neric quality-of-life instruments, the Sickness Impact Profile and the Shor t Form 36, and two utility assessments. RESULTS: The groups were well match ed with no significant differences in functional outcome. Quality-of-life s cores were high in both groups and there were no significant differences in overall quality of life between the two groups using all five instruments. There was evidence of a response shift phenomenon in the failed medical th erapy control group. CONCLUSION: Quality of life of patients who have a pel vic pouch for colitis-associated neoplasia is excellent and the same as tha t of patients who have a pouch for failure of medical therapy.