Laparoscopic versus Open surgery for small bowel Crohn's disease

Dasari, Bobby; McKay, Damian; Gardiner, Keith

doi:10.1002/14651858.cd006956.pub2

Cited by 119 publications

(83 citation statements)

References 15 publications

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“…With respect to the complication rate no superiority for the laparoscopic access could be shown by the data included in the Cochrane analysis. 32 We were not able to show any statistically significant differences with regard to complications of the surgical access. The complication rate in the open (33.3%) and the laparoscopic (22.4%) groups were not significantly different.…”

Section: Postoperative Outcomecontrasting

confidence: 53%

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Hoffmann¹,

Siebrasse²,

Schlöricke³

et al. 2017

OAS

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Aim:To investigate, via data analysis, the long-term outcome of patients who underwent either laparoscopic or open surgery for Crohn's disease. Methods: A total of 113 patients who had undergone first abdominal surgery due to Crohn's disease between January 2000 and December 2010 in a maximum care provider facility, were included in the statistical analysis. All patients provided their informed consent prior to inclusion. Data were collected from a database. Follow-up data included data from central mortality registries, general practitioners and a specialized clinic. Statistical analysis of the general patient data and the different operations and approaches were performed with the use of chi-square test, Fisher's exact test, and the Mann-Whitney U test. Results: The median follow-up period in case of open and laparoscopic surgery was found to be 9 and 6 years, respectively. Statistically significant differences were observed for the following parameters in case of open and laparoscopic surgery, respectively: age (median=44 vs. 36 years, range=15-76 vs. 15-72 years; p=0.007), urgency of operation (23 out of 34 planned vs. 6 out of 70 planned; p<0.001), year of resection (median=2003 vs. 2006, range=2000-2010 vs. 2000-2010; p=0.001). The length of stay in hospital was significantly shorter in the laparoscopic group than that of open surgery group (8 vs. 11 days, respectively; p<0.0001). We did not control for factors such as age and comorbidities in our statistical analysis. We also did not find any differences with regard to perioperative and 90-day mortality, surgical complications, length of specimen, stoma, surgical recurrence rate (10% in both groups) and number of re-admissions. Moreover, we did not find differences between patients with early operation after first symptoms and patients with long course of disease. A statistically significant difference was found for long-term mortality that was higher in the open surgery group than that of laparoscopic group (p=0.005) (the median for open surgery group was significantly higher than that of laparoscopic group). Conclusion: The outcome of laparoscopic and open surgery is at least comparable. Shorter length of hospital stay and comparable surgical recurrence rates are advantages of laparoscopy.

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Section: Postoperative Outcomecontrasting

confidence: 53%

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Hoffmann¹,

Siebrasse²,

Schlöricke³

et al. 2017

OAS

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“…Laparoscopic techniques have transformed colorectal surgery in the last decades, and meanwhile numer-Gardenbroek/Tanis/Buskens/Bemelman ous studies have shown the safety and advantages of laparoscopic surgery in Crohn's disease with reduced hospital stays, shorter times to first postoperative bowel movements, lower complication rates, better cosmetic outcomes and comparable disease recurrence rates for laparoscopic and open surgery [6][7][8][9][10][11][12][13][14]. In our opinion, the laparoscopic approach is preferable in patients with inflammatory bowel disease.…”

Section: Single-incision Laparoscopic Surgerymentioning

confidence: 85%

Surgery for Crohns Disease: New Developments

Gardenbroek

Tanis²,

Buskens³

et al. 2012

Dig Surg

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Background/Aims: Crohn’s disease is a chronic relapsing inflammatory bowel disease requiring surgery in a large number of patients. This review describes new developments in surgical techniques for treating Crohn’s disease. Results: Single-incision laparoscopic surgery decreases abdominal wall trauma by reducing the number of abdominal incisions, possibly improving postoperative results in terms of pain and cosmetics. The resected specimen can be extracted through the single-incision site or the future stoma site. Another option is to use natural orifices for extraction (i.e. transcolonic/transanal), but actual benefits of these procedures have not yet been determined. In patients with extensive perianal disease or rectal involvement, transperineal completion proctectomy is often feasible, thereby avoiding relaparotomy. By using a close rectal intersphincteric resection, damage to the pelvic autonomic nerves is avoided. In addition, the risk of presacral abscess formation is reduced by leaving the mesorectal tissue behind. Conclusion: Minimally invasive surgery and associated techniques have become standard clinical practice in surgical treatment of patients with Crohn’s disease. New developments aim at further reducing the hospital stay and morbidity, and improving the cosmetic outcomes.

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“…It is a chronic, relapsing-remitting disease characterised by granulomatous inflammation which can affect any part of the gastrointestinal system [3,4].Up to 30% of patients with CD develop a perianal fistula [3,5]. Perianal Crohn's fistula (pCD) is a debilitating manifestation of CD and adversely affects patient quality of life [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Assessing Internet Based Information Used to Aid Patient Decision Making in Surgery for Perianal Crohn's Fistula

Marshall

Baker

Lee

et al. 2017

International Journal of Surgery

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Background Decision-making in perianal Crohn's fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD. Methods A search of Google TM and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis. Written health information was assessed using the International Patient Decision Aids Standards (IPDAS) and DISCERN criteria. The readability of the source content was assessed using the Flesch-Kincaid score. Results Of the 201 sources found, 187 were excluded, leaving 14 sources for analysis. Three sources were dedicated to pCD, and six sources mentioned pCD-specific outcomes. The most common surgical intervention reported was seton insertion (n = 13). The least common surgical intervention reported was proctectomy (n = 1). The mean IPDAS and DISCERN scores were 4.43 ± 1.65 out of 12 (range = 2-8) and 2.93 ± 0.73 out of 5 (range = 1-5), respectively. The mean reading ease was US college standard. Conclusions We found no patient decision aids relating to surgery for pCD. The online sources relating to surgery for pCD are few, and their quality is poor, as seen in the low IPDAS and DISCERN scores. Less than half of the sources mentioned pCD-specific outcomes, and three sources were solely dedicated to providing information on pCD. Healthcare professionals should look to create a patient tool to assist decision-making in pCD.

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Laparoscopic versus Open surgery for small bowel Crohn's disease

Abstract: Laparoscopic surgery for small bowel CD may be as safe as the open operation. There was no significant difference in the perioperative outcomes and the long term reoperation rates for disease-related or non-disease related complications of CD.

Cited by 119 publications

References 15 publications

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Surgery for Crohns Disease: New Developments

Assessing Internet Based Information Used to Aid Patient Decision Making in Surgery for Perianal Crohn's Fistula

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Laparoscopic versus Open surgery for small bowel Crohn's disease

Abstract: Laparoscopic surgery for small bowel CD may be as safe as the open operation. There was no significant difference in the perioperative outcomes and the long term reoperation rates for disease-related or non-disease related complications of CD.

Cited by 119 publications

References 15 publications

Long-term outcome of laparoscopic and open surgery in patients with Crohn&rsquo;s disease

Long-term outcome of laparoscopic and open surgery in patients with Crohn&rsquo;s disease

Surgery for Crohns Disease: New Developments

Assessing Internet Based Information Used to Aid Patient Decision Making in Surgery for Perianal Crohn's Fistula

Contact Info

Product

Resources

About

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Surgery for Crohns Disease: New Developments