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Laparoscopic surgery for recurrent Crohn's disease.

H Hasegawa1, M Watanabe, H Nishibori

  • 1Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. hasegawa@sc.itc.keio.ac.jp

The British Journal of Surgery
|August 9, 2003
PubMed
Summary

Laparoscopic surgery is feasible for recurrent Crohn's disease, even in reoperations. This minimally invasive approach offers comparable outcomes to primary procedures for patients with Crohn's disease.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Crohn's disease recurrence often necessitates reoperation.
  • Laparoscopic surgery is increasingly utilized for gastrointestinal procedures.
  • Assessing the safety and efficacy of repeat laparoscopic surgery for Crohn's disease is crucial.

Purpose of the Study:

  • To evaluate the feasibility of laparoscopic surgery for recurrent Crohn's disease.
  • To determine the role of repeated laparoscopy in reoperation for Crohn's disease.
  • To compare outcomes of laparoscopic surgery for recurrent versus primary Crohn's disease.

Main Methods:

  • A retrospective study of 52 patients undergoing 61 laparoscopic operations for ileal or ileocolonic Crohn's disease between 1994 and 2002.

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  • 16 procedures were for recurrent disease (recurrent group), and 45 were primary procedures (control group).
  • Median follow-up was 48 months.

    • Main Results:

    • No significant difference in enteric fistula or conversion rates between recurrent and control groups.
    • Operating time was longer in the recurrent group, but postoperative complications and hospital stay were similar.
    • Median time to reoperation was 46 months.

    Conclusions:

    • Laparoscopic surgery is a feasible option for selected patients with recurrent Crohn's disease.
    • Repeat laparoscopy for recurrent Crohn's disease does not increase conversion rates or postoperative complications.
    • Minimally invasive surgery can be safely employed in managing recurrent Crohn's disease.