Laparoscopic versus Open Bowel Resection for Crohn's Disease

Abstract

Laparoscopic resection for Crohn's disease can be performed safely and effectively. Quicker resumption of oral feeds, less postoperative pain and earlier discharge from hospital are advantages of the laparoscopic method. No differences in the recurrence rate or the disease-free interval were noted.

Short-Term Outcomes after Laparoscopic Ileocolic Resection for Crohn’s Disease

“…1). Of 27 publications that were considered potentially relevant[2,3,4, 8, 9,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33], 13 were subsequently excluded due to the reasons given in figure 1[14,18,19,20,21,24,25,26,27, 29, 30, 33]. Fourteen studies published between 1995 and 2006 met the inclusion criteria [2,3,4, 8, 9, 12, 13, 15, 17, 22, 23, 28, 31, 32].…”

“…This has resulted in the exclusion of two poor quality studies[ 23, 41] from the present meta-analysis. In addition, the studies of Msika et al[ 26], Luan and Gross[ 24] and Tabet et al[ 29] were not included because the substantial number of patients having various extended procedures like proctocolectomies and segmental colectomies likely would have affected outcome. Finally, the most recently conducted randomized controlled trial was not included in any of the previous reviews or the other meta-analysis.…”

“…These differences probably explain why the present meta-analysis could not substantiate the firm conclusions from the previous meta-analysis by Rosman et al [10] regarding earlier return to full liquid diet, first bowel movement, first flatus, and their conclusions about estimated intraoperative blood loss, conversion rate, and complications requiring reoperation and reported overall complications. As the authors of the other meta-analysis state, statistical significance with regard to advantages of laparoscopy on long-term outcome was driven mainly by the study of Tabet et al[ 29]. This particular study however also included patients requiring left hemicolectomy, segmental colonic resection, and even abdominoperineal resection.…”

Postoperative Crohn’s disease recurrence: A practical approach

“…This technique can be performed safely and effectively and it shows a faster resumption of oral feeds, lesser postoperative pain, and shorter hospital stay when compared to open surgery. No differences were found in the recurrence rate or the disease-free interval when laparoscopic technique was compared with open surgery in a retrospective analysis of 61 consecutive patients performed in a tertiary Canadian centre [33] . Similar results were obtained in a retrospective study involving a larger cohort of 113 patients [34] .…”

Surgical Treatment of Severe Inflammatory Bowel Diseases

“…Other advantages such as less postoperative intra-abdominal adhesions and improved cosmetic results may be particularly attractive in patients who are likely to undergo multiple operations during their lifetime [21]. No differences in recurrence rate or in disease-free interval were noted between groups of patients operated on with an open technique or laparoscopically [22]. If the surgeon has enough experience in minimal invasive surgery, primary surgery should be performed with a laparoscopically assisted technique.…”