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

Abstract

Background: No consensus exists whether ileocolic resection for Crohn’s disease (CD) should be carried out by a laparoscopic or open approach. A systematic review was conducted to assess the evidence for short-term advantages of laparoscopic compared to open resection for ileocolic CD. Methods: The literature search was conducted over the period 01/1991 to 02/2006. Only randomized controlled trials (RCTs), clinical controlled trials and comparative studies comparing laparoscopic with open resection for ileocolic CD were included. A quality assessment was performed for all retrieved articles. The main outcome parameters were operating times, conversion rates, major and minor morbidity and hospital stays. Results: 14 publications encompassing 729 patients were included – 2 were RCTs, 12 were non-RCTs of which 2 were case-matched studies. Although pooling data of operating times was statistically not possible, they were longer for the laparoscopic procedure in the individual studies ranging from 75 to 185 min. Conversions varied between 0 and 16.7%. Postoperative complications requiring reoperation or reported overall morbidity were not different (risk difference –0.01 and –0.05, respectively). Hospital stay after the laparoscopic procedure was 1.90 days shorter (95% CI: 0.83–2.97). Conclusion: There is evidence that laparoscopic ileocolic resection for CD is associated with shorter hospital stay compared to open ileocolic resection, while morbidity rates are equal and conversion rates are acceptable

Outcomes after laparoscopic surgery in children with inflammatory bowel disease

“…It is also important to note that we adopted a broad and comprehensive approach to the documentation of complications. This notion is supported by the fact that only one patient (1.2%) underwent reoperation within 30 days, which compares favorably with the 7.6% rate of reoperation in the studies reviewed by Polle et al [7].…”

“…The incidence of complications following small bowel/ileocolic resection is higher than the 8-21% cited for the studies examined by Polle et al [7] in their systematic review of studies comparing open versus laparoscopic ileocolic resection. This may be related to the relatively high acuity of patients treated, with 94% receiving some form of medical management at the time of surgery.…”

Clinical literature review of 1858 Crohn's disease cases requiring surgery in China

“…Stricturcoplasty is a safe alternative to resection in jejuno-ileal CD, including ileocolonic recurrence [24] . Additionally, most of studies reported that laparoscopic surgery for CD is feasible and safe and is associated with a shorter hospital stay and a better shortterm outcome compared with open resection [25][26][27][28] . Laparoscopic surgery is preferred for ileocolonic resections.…”

Surgery for Crohn’s Disease: New Developments

“…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.…”