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Laparoscopic surgery for recurrent ileocolic Crohn's disease
Stefan D Holubar1, Eric J Dozois, Antonio Privitera
1Division of Colon and Rectal Surgery, Mayo Clinic Rochester, Minnesota, USA.
Inflammatory Bowel Diseases
|December 23, 2009
Summary
Laparoscopic surgery for recurrent ileocolic Crohn's disease is safe and feasible. While adhesions may necessitate conversion to open surgery, it does not increase complications, offering short-term benefits.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic surgery is common for primary ileocolic Crohn's disease.
- Its use in recurrent cases is less understood.
- This study evaluates laparoscopic approach safety and feasibility in recurrent ileocolic Crohn's disease.
Purpose of the Study:
- To assess the safety and feasibility of laparoscopic surgery for recurrent ileocolic Crohn's disease.
- To identify short-term benefits of this approach in patients with recurrent disease.
Main Methods:
- Retrospective analysis of 40 patients undergoing laparoscopic surgery for recurrent ileocolic Crohn's disease (1998-2008).
- Univariate analysis of risk factors for conversion to open surgery and patient outcomes.
- Comparison between completed laparoscopic and converted open surgery groups.
Main Results:
- 75% of patients completed laparoscopic surgery; 25% were converted to open surgery.
- Converted patients more frequently required adhesiolysis (100% vs 67%, P=0.04).
- Conversion led to longer hospital stays (7 vs 4 days, P=0.003) and delayed diet advancement (4 vs 3 days, P=0.03) without increased morbidity.
Conclusions:
- Adhesions can prevent successful laparoscopic re-resection in up to 20% of patients.
- Conversion to open surgery increases length of stay but not morbidity.
- Laparoscopic surgery is safe and offers short-term benefits for selected patients with recurrent ileocolic Crohn's disease.
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