title: Short-term outcomes after laparoscopic ileocolic resection for Crohn's disease. A systematic review.
abstract: BACKGROUND
  No consensus exists whether ileocolic resection for Crohn's disease (CD) should be carried out by a laparoscopic or open approach. A systematic review was conducted to assess the evidence for short-term advantages of laparoscopic compared to open resection for ileocolic CD.
  
  
  METHODS
  The literature search was conducted over the period 01/1991 to 02/2006. Only randomized controlled trials (RCTs), clinical controlled trials and comparative studies comparing laparoscopic with open resection for ileocolic CD were included. A quality assessment was performed for all retrieved articles. The main outcome parameters were operating times, conversion rates, major and minor morbidity and hospital stays.
  
  
  RESULTS
  14 publications encompassing 729 patients were included - 2 were RCTs, 12 were non-RCTs of which 2 were case-matched studies. Although pooling data of operating times was statistically not possible, they were longer for the laparoscopic procedure in the individual studies ranging from 75 to 185 min. Conversions varied between 0 and 16.7%. Postoperative complications requiring reoperation or reported overall morbidity were not different (risk difference -0.01 and -0.05, respectively). Hospital stay after the laparoscopic procedure was 1.90 days shorter (95% CI: 0.83-2.97).
  
  
  CONCLUSIONS
  There is evidence that laparoscopic ileocolic resection for CD is associated with shorter hospital stay compared to open ileocolic resection, while morbidity rates are equal and conversion rates are acceptable.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Sebastiaan W
authors.initials: SW
authors.lastname: Polle
authors.forename: Jan
authors.initials: J
authors.lastname: Wind
authors.forename: Dirk T
authors.initials: DT
authors.lastname: Ubbink
authors.forename: Daan W
authors.initials: DW
authors.lastname: Hommes
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: Willem A
authors.initials: WA
authors.lastname: Bemelman
mesh_terms: D016009:Chi-Square Distribution; D003106:Colon / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery*; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation