[Laparoscopically assisted surgery in Crohn disease].
From Jan. 1993 to Apr. 1997 intestinal resections in Crohn's disease have been performed in 275 patients. 89 patients have been operated on laparoscopic assisted. The following parameters were analyzed: previous laparotomies, extent of resection, steroid medication, conversionrate, complications, operative time and postoperative stay. Endpoints were: conversionrate, complications, reconvalescence and overall satisfaction with the laparoscopic technique.


RESULTS
The duration of the disease ranged from 1 to 16 years (x = 6). 47 patients were under steroid medication at the time of surgery. 30 patients had undergone previous laparotomies. In 10 patients the operation had to be converted into open surgery. The following procedures have been performed: ileocaecal resections (45), anastomotic resections (14), small bowel resections (4), hemicolectomies (12), colectomies (9), loopileostomies (4), adhesiolysis (1). Minor complications occurred in 6.7% of patients, major complications in 5.6%. Operative time ranged from 70 to 420 minutes (x = 173.7). The postoperative hospital stay was 13.3 days in the average.


CONCLUSIONS
The morbidity of 12.3% is not higher than in open surgery. When complications do not occur the patients benefit from early convalescence, better cosmetics and shorter hospital stay.
Hildebrandt
U
U
Abteilung für Allgemeine Chirurgie, Abdominal-, und Gefässchirurgie, Universität des Saarlandes, Homburg/Saar.
Schiedeck
T
T
Kreissler-Haag
D
D
Lindemann
W
W
Ecker
K W
KW
Bruch
H P
HP
Feifel
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002432:Cecum / Q000601:surgery; D003082:Colectomy / Q000295:instrumentation; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000295:instrumentation; D007082:Ileum / Q000601:surgery; D020706:Laparoscopes; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents
Laparoskopisch assistierte Chirurgie bei M. Crohn.