Laparoscopic resection for primary and recurrent Crohn's disease: A case series of over 100 consecutive cases

Laparoscopic surgery for patients with Crohn's disease (CD) is considered challenging. The aim of this study is to evaluate the clinical outcomes of laparoscopic bowel resection in patients with CD. We also assessed the effectiveness of the laparoscopic approach in recurrent or emergency surgery due to CD.

All patients with CD, who underwent laparoscopic resection surgery in two units from October 2006 to February 2016, were identified through prospectively maintained databases. Their baseline characteristics and perioperative outcomes were analysed. The outcomes of patients receiving primary vs recurrent and elective vs emergency laparoscopic resections for CD were also examined.

In total 106 patients underwent laparoscopic resection. Primary ileocolic resection was the most frequent procedure (62%) followed by redo-ileocolic resection (15%). Overall conversion rate was 4.7%, median operative time was 130 (95-185) minutes and length of stay was 4 days (3-6). There was one anastomotic leak (1.1%) and 30-day re-operation rate was 5.7%. Patients having primary resections were younger and had a shorter length of stay (4 vs 5 days; p = 0.014). Thirty day re-operation rate was higher in patients having emergency surgery (3.1% vs 30%; p = 0.011).

This case series demonstrates that laparoscopic resection surgery for CD is safe and feasible. Similarly, laparoscopic surgery is also a viable option for patients having recurrent resection and possibly even emergency surgery.