Ileocecal valve syndrome and vitamin b12 deficiency after surgery: a multicentric prospective study
Open Access
- 9 July 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Updates in Surgery
- Vol. 73 (2), 569-580
- https://doi.org/10.1007/s13304-020-00845-z
Abstract
Patients undergoing colon resection are often concerned about their functional outcomes after surgery. The primary aim of this prospective, multicentric study was to assess the intestinal activity and health-related quality-of-life (HRQL) after ileocecal valve removal. The secondary aim was to evaluate any vitamin B12 deficiency. The study included patients undergoing right colectomy, extended right colectomy and ileocecal resection for either neoplastic or benign disease. Selected items of GIQLI and EORTC QLQ-CR29 questionnaires were used to investigate intestinal activity and HRQL before and after surgery. Blood samples for vitamin B12 level were collected before and during the follow-up period. The empirical rule effect size (ERES) method was used to explain the clinical effect of statistical results. Linear mixed effect (LME) model for longitudinal data was applied to detect the most important parameters affecting the total score. A total of 158 patients were considered. Applying the ERES method, the analysis of both questionnaires showed clinically and statistically significant improvement of HRQL at the end of the follow-up period. Applying the LME model, worsening of HRQL was correlated with female gender and ileum length when using GIQLI questionnaire, and with female gender, open approach, and advanced cancer stage when using the EORTC QLQ-CR29 questionnaire. No significant deficiency in vitamin B12 levels was observed regardless of the length of surgical specimen. In our series, no deterioration of HRQL and no vitamin B12 deficiency were found during the follow-up period. Nevertheless, warning patients about potential changes in bowel habits is mandatory. In our series, no deterioration of HRQL and no vitamin B12 deficiency were found during the follow-up period. Nevertheless, warning patients about potential changes in bowel habits is mandatory.Keywords
This publication has 28 references indexed in Scilit:
- Review article: small intestinal bacterial overgrowth - prevalence, clinical features, current and developing diagnostic tests, and treatmentAlimentary Pharmacology & Therapeutics, 2013
- Prospective evaluation of health-related quality of life after laparoscopic colectomy for cancerTechniques in Coloproctology, 2012
- Small intestinal bacterial overgrowth syndromeWorld Journal of Gastroenterology, 2010
- Assessing quality of life in patients with colorectal cancer: An update of the EORTC quality of life questionnaireEuropean Journal of Cancer, 2007
- Vitamin B12 deficiency following restorative proctocolectomy1Colorectal Disease, 2007
- Vitamin B12 malabsorption in patients with limited ileal resectionNutrition, 2006
- The ileocolonic sphincterNeurogastroenterology & Motility, 2005
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Bowel function survey after segmental colorectal resectionsDiseases of the Colon & Rectum, 1996
- Measurement of health status: Ascertaining the minimal clinically important differenceControlled Clinical Trials, 1989