[Surgical training on intestinal resections for Crohn's disease : A retrospective analysis of postoperative...

Surgical training in laparoscopic colorectal surgery is characterized by structural deficits and extensive inhomogeneity. Ileocolic resections in Crohn's disease provide an ideal setting for structured training procedures. The aim of this retrospective study was to evaluate the outcomes of intestinal resections in patients with Crohn's disease performed by surgical residents under supervision in a specialized center.

Between October 2021 and August 2025 a total of 361 intestinal resections in patients with Crohn's disease were performed. Of the procedures 90 (25%) were carried out entirely by residents under supervision. Patient characteristics, operative details and postoperative outcomes were analyzed. The primary endpoint was the rate of intra-abdominal septic complications (IASC).

The residents performed primary ileocolic resections in patients with non-penetrating inflammation who had not previously undergone surgery significantly more frequently. The overall postoperative complication rate was 26%, with IASC occurring in 8% of cases, including 5% near to the anastomosis. The postoperative morbidity was not increased in operations performed by residents, on the contrary the rates of IASC (1% vs. 10%, p = 0.003) and anastomotic complications (1% vs. 7%, p = 0.046) were significantly lower. Multivariate analysis identified preoperative weight loss (> 5%) and non-ileocolic resections as independent risk factors for IASC.

Primary ileocolic resections for Crohn's disease are ideal training procedures in laparoscopic colorectal surgery. With appropriate patient selection and close medical supervision, residents can safely perform these operations and with a low morbidity. The results support the integration of such resections as a core component of a structured operative curriculum.