Videocirurgia no manejo da doença de Crohn intestinal

Araújo, Sérgio Eduardo Alonso; Dias, André Roncon; Seid, Víctor Edmond; Campos, Fábio Guilherme; Nahas, Sérgio Carlos

doi:10.1590/s0101-98802010000300001

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…It is estimated that approximately 70 to 90% of patients will require some form of surgical treatment throughout their lifetime. 1,2 The role of laparoscopic surgery in the management of colorectal diseases is well established, with numerous benefits in both benign and oncologic resections. 3 However, laparoscopic surgery in CD has been shown to be challenging due to the inflammatory, transmural and recurrent characteristics of this condition.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 The presence of active inflammation, mes-entery infiltration and friability, presence of fistulae, adhesions and concomitant immunosuppression can significantly complicate a procedure that already has intrinsic difficulties even when using the conventional approach. 2,6 In spite of these characteristics, laparoscopic surgery has been increasingly performed in the management of CD, especially in primary ileocolic disease. 7 Recent studies have demonstrated that this is a feasible, safe, effective procedure, which shows benefits in postoperative recovery, even in the presence of abscesses and intestinal fistulae.…”

Section: Introductionmentioning

confidence: 99%

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Complications after intestinal resection in Crohn's disease: laparoscopic versus conventional approach

Kotze

Abou-Rejaile

Barcelos

et al. 2013

Journal of Coloproctology

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Background significant advances in medical therapy for Crohn's disease (CD) occurred in the last 12 years, mainly due to the introduction of anti-TNF therapy. Laparoscopic colorectal surgery represented the most important advance on surgical treatment in the management of CD, as it also had developed in the treatment of other conditions. There is a tendency for lower complication rates after laparoscopic bowel resections as compared to open surgery. The aim of this study was to analyze and compare the complication rates after bowel resections for CD between the two approaches in a Brazilian case series. Methods this was a retrospective longitudinal study, including CD patients submitted to bowel resections from a single Brazilian Inflammatory Bowel Diseases (IBD) referral center, treated between January 2008 and June 2012 with laparoscopic approach (LA) or conventional approach (CA). Variables analyzed age at surgery, gender, Montreal classification, smoking, concomitant medication, type of surgery, surgical approach, presence and type of complication up to 30 days after the procedures. Readmission and reoperation rates, as well as mortality, were also analyzed. Patients were allocated in two groups regarding the type of procedure (LA or CA), and complication rates and characteristics were compared. Statistical analysis was performed with Mann-Whitney test (quantitative variables) and chi-square test (qualitative variables), with p < 0.05 considered significant. Results a total of 46 patients (25 men) were included (16 submitted to LA), with mean age of 38.1 (± 12.7) years. The groups were considered homogeneous according to age, gender, CD location, perianal disease and concomitant medications. There were more patients with fistulizing CD on the CA group (p = 0.029). The most common procedure performed was ileocolic resection on both groups (56.7% of the CA and 75% of the LA patients – p = 0.566). Overall, total complications (surgical and medical, including minor and major issues) occurred in 60% (18/30) of the CA group and 12.5% (2/16) of the LA group (p = 0.002). Wound infection was the most frequent complication (10/30 on CA and 1/16 on the LA groups). There were 3 deaths in the CA group. Specific analysis of each complication did not demonstrate any difference between the groups regarding abdominal sepsis, urinary tract infections, pneumonia, readmission, reoperations and deaths (p = 0.074). Conclusions there was a higher complication rate in patients operated with CA as compared to LA. This was probably due to patient selection for the laparoscopic approach, with severe cases, mostly due to fistulizing abdominal CD, being operated mainly by open surgery. LA tends to be the recommended approach in most cases of non-complicated CD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Complications after intestinal resection in Crohn's disease: laparoscopic versus conventional approach

Kotze

Abou-Rejaile

Barcelos

et al. 2013

Journal of Coloproctology

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Doença de Crohn - uma revisão

Santolin,

Vidigal,

Da Silva

et al. 2023

Cuad. Ed. Desar.

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A Doença de Crohn é uma doença crônica de etiologia multifatorial e faz parte do grupo das doenças inflamatórias intestinais, acometendo qualquer parte do trato gastrointestinal, mas tendo como região principal o íleo terminal. A principal característica é ser transmural e com inúmeros sintomas associados à processos inflamatórios agudizados. O diagnóstico é baseado em um conjunto de fatores que engloba desde a história clínica até exames complementares. O tratamento inclui medidas farmacológicas e não farmacológicas. Esta doença pode afetar qualquer gênero, mas é mais preponderante em mulheres, sendo a faixa etária mais acometida entre os 20 e 40 anos, com uma segunda onda aos 55 anos. Sua incidência e prevalência é maior em países em desenvolvimento e no Brasil ainda faltam dados para a definição do perfil epidemiológico. Esta revisão bibliográfica buscou aspectos epidemiológicos, fisiopatológicos, clínicos, além do método diagnóstico e tratamentos disponíveis atualmente. Para obtenção das informações, foi realizada uma revisão a partir de bases de dados online Lilacs, Biblioteca Virtual em Saúde (BVS), PubMed, Scientific Eletronic Libary Online (SciELO), Portal de periódicos capes MEC e Google Acadêmico, além disso foram utilizados alguns critérios de inclusão: estudos observacionais, descritivos, revisões sistemáticas, estudo de caso, cenário nacional e internacional, publicação nos diferentes idiomas, no período de 2007 a 2020. Foram encontradas 76 bibliografias, das quais 34 se tornaram elegíveis para o presente estudo.

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Videocirurgia no manejo da doença de Crohn intestinal

Cited by 2 publications

References 41 publications

Complications after intestinal resection in Crohn's disease: laparoscopic versus conventional approach

Complications after intestinal resection in Crohn's disease: laparoscopic versus conventional approach

Doença de Crohn - uma revisão

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