Laparoscopic surgery for patients with Crohn's colitis: a case-matched study.
BACKGROUND
The purpose of this study was to compare short and long-term outcomes of laparoscopic colectomy with open colectomy in patients with Crohn's disease confined to the colon.


METHODS
We reviewed all patients undergoing laparoscopic colectomy for Crohn's disease at our institution between 1994 and 2005. Laparoscopic colectomies were matched to open colectomies by patient age, gender, American Society of Anesthesiologists score, type, and year of surgery. We excluded patients with concomitant small bowel disease.


RESULTS
Twenty-seven laparoscopic cases were matched with 27 open cases. There were seven conversions (26%). There was no mortality. Median operative times were significantly longer after laparoscopic colectomy (240 vs 150 min, P < 0.01), and estimated blood loss was comparable (325 vs 350 ml, P = 0.4). Postoperative complications were similar. Laparoscopic colectomies had shorter median length of stay (5 vs 6 days, P = 0.07) and median time to first bowel movement (3 vs 4 days, P = 0.4). When overall length of stay included 30-day readmissions, the difference in favor of laparoscopy became statistically significant (P = 0.02). Recurrent disease requiring surgery was decreased after laparoscopy, although median follow-up was significantly shorter.


CONCLUSIONS
Laparoscopic colectomy is a safe and acceptable option for patients with Crohn's colitis. Longer follow-up is needed to accurately establish recurrence rates.
da Luz Moreira
Andre
A
Department of Colorectal Surgery, A30, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Stocchi
Luca
L
Remzi
Feza H
FH
Geisler
Daniel
D
Hammel
Jeffery
J
Fazio
Victor W
VW
D000328:Adult; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D003082:Colectomy / Q000379:methods; D003092:Colitis / Q000601:surgery*; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome