Laparoscopic versus open ileo-colonic resection in Crohn's disease: short- and long-term results from a prospective longitudinal study.
Possible relations between surgical approaches, frequency, and severity of Crohn's disease recurrence after ileo-colonic resection is unknown. We aimed to assess perioperative outcomes and postsurgical complications of laparoscopic versus standard open surgery and to detect differences between the two groups in endoscopical recurrence and patients' satisfaction. Twenty-eight consecutive patients undergoing elective ileo-colonic resection by either laparoscopic approach (n = 15) or conventional open surgery (n = 13) were prospectively enrolled. No mortality or major intraoperative complications were observed in both groups. Significant differences between groups were the median operating time found shorter in the open group than in the laparoscopic group (p = 0.003), the higher dosage of pain killers needed in the open group (p = 0.05), the passage of flatus and\or stool after surgery found faster in group A (p = 0.004) and the shorter recovery period in the laparoscopic group (p = 0.007). Colonoscopy was performed in 27 patients. The frequency and pattern of recurrence did not differ between the two groups (p = 0.63). Patients' satisfaction was significantly in favor of laparoscopy. Present findings support the feasibility and advantages in the short-term of laparoscopic ileo-colonic resection in patients with Crohn's disease. No differences were observed in terms of frequency, time of onset, and severity of recurrence in a 1-year follow-up.
Sica
Giuseppe S
GS
Dipartimento di Chirurgia, Unità di Chirurgia Generale, Università di Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. sica.giuseppe@fastwebnet.it
Iaculli
Edoardo
E
Benavoli
Domenico
D
Biancone
Livia
L
Calabrese
Emma
E
Onali
Sara
S
Gaspari
Achille L
AL
D000293:Adolescent; D000328:Adult; D053704:Capsule Endoscopy; D003082:Colectomy / Q000379:methods*; D003424:Crohn Disease / Q000175:diagnosis / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome