Metaanalysis of trials comparing laparoscopic and open surgery for Crohn's disease.
BACKGROUND
Several studies in the literature have suggested that laparoscopic surgery for Crohn's disease is associated with faster postoperative recovery and a morbidity and recurrence rate similar to that for open surgery. Most of these studies have been limited by a small sample size and a short follow-up period.


METHODS
To clarify whether open or laparoscopic resection results in a better outcome, a metaanalysis of studies was performed comparing the two procedures for Crohn's disease. Pooled effects were estimated using a random-effects model.


RESULTS
Laparoscopic surgery required more operative time than open surgery (26.8 min; 95% confidence interval [CI], 6.4-47.2 min), but resulted in a shorter duration of ileus and a decreased hospital stay (-2.62 days; 95% CI, -3.62 to -1.62). Laparoscopic surgery also was associated with a decreased rate for postoperative bowel obstruction and surgical recurrences.


CONCLUSIONS
Laparoscopic surgery for Crohn's disease is feasible, safe, and associated with shorter duration of ileus and a shorter hospital stay.
Rosman
A S
AS
Section of Gastroenterology and Medicine Program, Bronx VAMC and Mount Sinai School of Medicine, New York, NY, USA. Alan.Rosman@Med.VA.Gov
Melis
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Fichera
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D002986:Clinical Trials as Topic; D003424:Crohn Disease / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology