title: Advantages of laparoscope-assisted surgery for recurrent Crohn's disease.
abstract: BACKGROUND
  Laparoscopic surgery has been applied to patients with primary Crohn's disease, and its beneficial outcomes have been already investigated. However, there is no systematic study of laparoscopic surgery for patients with recurrent diseases.
  
  
  METHODS
  We performed reoperation for 43 patients with recurrent Crohn's disease, including 23 patients who underwent laparoscope-assisted surgery.
  
  
  RESULTS
  For all the patients, laparoscope-assisted surgery could be performed safely, even if the patients had been treated previously by open surgery or had undergone multiple abdominal procedures. Conversion to open or hand-assisted laparoscopic surgery was necessary for 16 patients (69.6%) because of dense adhesions (11 cases) or bulky tumor (5 cases). Importantly, even if the procedure was converted, the skin incision was significantly shorter than with open surgery, and postoperative recovery was faster, especially for the patients who underwent conversion to hand-assisted laparoscopic surgery.
  
  
  CONCLUSIONS
  Laparoscope-assisted surgery is feasible and advantageous in reoperation for patients with recurrent Crohn's disease.
authors.affiliation: Department of Surgery, Osaka University Graduate School of Medicine, E1 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. fuchi@surg1.med.osaka-u.ac.jp
authors.forename: F
authors.initials: F
authors.lastname: Uchikoshi
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: R
authors.initials: R
authors.lastname: Nezu
authors.forename: M
authors.initials: M
authors.lastname: Tanemura
authors.forename: Y
authors.initials: Y
authors.lastname: Kai
authors.forename: T
authors.initials: T
authors.lastname: Mizushima
authors.forename: K
authors.initials: K
authors.lastname: Nakajima
authors.forename: H
authors.initials: H
authors.lastname: Tamagawa
authors.forename: C
authors.initials: C
authors.lastname: Matsuda
authors.forename: H
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome