National Trends and Outcomes for the Surgical Therapy of Ileocolonic Crohn’s Disease: A Population-Based Analysis of Laparoscopic vs. Open Approaches

Lesperance, Kelly; Martin, Matthew J.; Lehmann, R; Brounts, Lionel R.; Steele, Scott R.

doi:10.1007/s11605-009-0853-3

Cited by 84 publications

(58 citation statements)

References 27 publications

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“…This bias may be associated with preselection by the surgeons with regard to clinical conditions and was corresponding to current guideline recommendations as well as the results of other study groups that investigated retrospective cohorts of patients with Crohn's disease. 7,8 The main key point of laparoscopic surgery is the often very young age of the patients and the risk of surgical recurrence because of the chronic nature of the disease. 9,10 In addition, it is presumed that a laparoscopic access allows faster recovery and return to work.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“…7,8 In one study, of the total 1,917 patients, the patients of open surgery group had median age of 42 years, whereas it was 37 years in the laparoscopic group. 7 Similar results were obtained by the second study in which 50,000 patients were included with abdominal surgery due to Crohn's disease in their analysis.…”

Section: Discussionmentioning

confidence: 99%

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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“…Recently in a prospective study, Goyer et al [21] of complications, shorter length of stay, and reduced mortality. Open operations were more likely performed for patients in fistulizing disease and when an ostomy was necessary [22] . This indicates that there is still a need for conventional surgery in patients with Crohn's disease, especially for those with complicated disease and repetitive surgery.…”

Section: Laparoscopic Surgery For Crohn's Diseasementioning

confidence: 99%

Minimally invasive surgery for inflammatory bowel disease: Review of current developments and future perspectives

Neumann¹,

Rijcken²

2016

WJGPT

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“…A review published by Lesperance in 2009 found that minimally invasive techniques were used in only 6 % of the 50,000 interventions performed in the United States in 2000-2004 for Crohn's disease, and this figure showed little or no change over the 5-year period examined by the authors. However, these data were extracted from hospital discharge forms examined at the national level, and they contrast with those from surgical referral centers, where the rate of laparoscopic procedures is much higher [116].…”

Section: Laparoscopy and Crohn's Diseasementioning

confidence: 99%

Surgery and diagnostic imaging in abdominal Crohn’s disease

et al. 2013

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Surgery is well-established option for the treatment of Crohn's disease that is refractory to medical therapy and for complications of the disease, including strictures, fistulas, abscesses, bleeding that cannot be controlled endoscopically, and neoplastic degeneration. For a condition like Crohn's disease, where medical management is the rule, other indications for surgery are considered controversial, because the therapeutic effects of surgery are limited to the resolution of complications and the rate of recurrence is high, especially at sites of the surgical anastomosis. In the authors' opinion, however, surgery should not be considered a last-resort treatment: in a variety of situations, it should be regarded as an appropriate solution for managing this disease. Based on a review of the literature and their own experience, the authors examine some of the possibilities for surgical interventions in Crohn's disease and the roles played in these cases by diagnostic imaging modalities.Riassunto La chirurgia è un'opzione terapeutica consolidata per il trattamento della malattia di Crohn refrattaria alla terapia medica e per le complicanze legate a tale patologia quali stenosi, fistole, ascessi, sanguinamento non trattabile endoscopicamente, oltre che per i casi di degenerazione neoplastica. Per condizioni come la malattia di Crohn nelle quali il trattamento medico ha un ruolo primario, altre indicazioni per la chirurgia sono controverse, poiché i suoi effetti terapeutici sono limitati alla risoluzione delle complicanze, e la frequenza di recidive è alta, soprattutto a livello dell'anastomosi. Secondo l'opinione degli autori, tuttavia, la chirurgia non deve essere considerata come ultima opzione di trattamento: in diverse situazioni dovrebbe essere ritenuta come una soluzione adeguata nel trattamento multidisciplinare della patologia. Basandosi sulla revisione della letteratura corrente e sulla propria esperienza, gli autori hanno esaminato alcune possibilità di intervento chirurgico nella malattia di Crohn ed il ruolo che svolgono in queste condizioni le tecniche di imaging.

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National Trends and Outcomes for the Surgical Therapy of Ileocolonic Crohn’s Disease: A Population-Based Analysis of Laparoscopic vs. Open Approaches

Abstract: A variety of patient- and system-related factors influence the utilization of laparoscopy in Crohn's disease. Laparoscopic resection is associated with excellent short-term outcomes compared to open surgery.

Cited by 84 publications

References 27 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

Minimally invasive surgery for inflammatory bowel disease: Review of current developments and future perspectives

Surgery and diagnostic imaging in abdominal Crohn’s disease

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National Trends and Outcomes for the Surgical Therapy of Ileocolonic Crohn’s Disease: A Population-Based Analysis of Laparoscopic vs. Open Approaches

Abstract: A variety of patient- and system-related factors influence the utilization of laparoscopy in Crohn's disease. Laparoscopic resection is associated with excellent short-term outcomes compared to open surgery.

Cited by 84 publications

References 27 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

Minimally invasive surgery for inflammatory bowel disease: Review of current developments and future perspectives

Surgery and diagnostic imaging in abdominal Crohn’s disease

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