Long-term surgical recurrence, morbidity, quality of life, and body image of laparoscopic-assisted vs. open ileocolic resection for Crohn's disease: a comparative study.
OBJECTIVE
Several studies have compared conventional open ileocolic resection with a laparoscopic-assisted approach. However, long-term outcome after laparoscopic-assisted ileocolic resection remains to be determined. This study was designed to compare long-term results of surgical recurrence, quality of life, body image, and cosmesis in patients who underwent laparoscopic-assisted or open ileocolic resection for Crohn's disease.


METHODS
Seventy-eight consecutive patients who underwent ileocolic resection during the period 1995 to 1998 were analyzed; 48 underwent a conventional open approach in the Academic Medical Centre (Amsterdam, The Netherlands) and 30 underwent a laparoscopic-assisted approach in the Leiden University Medical Centre (Leiden, The Netherlands). Primary outcome parameters were reoperation and readmission rate. Secondary outcome parameters were quality of life, body image, and cosmesis.


RESULTS
The two groups were comparable for characteristics of sex, age, and immunosuppressive therapy. Seventy-one patients had a complete follow-up of median 8.5 years. Resection for recurrent Crohn's disease was performed in 6 of 27 (22 percent) and 10 of 44 (23 percent) patients in the laparoscopic and open groups, respectively. Reoperations for incisional hernia were only performed after conventional open ileocolic resection (3/44 = 6.8 percent). Quality of life and body image were comparable, but cosmesis scores were significantly higher in the laparoscopic group.


CONCLUSIONS
Despite small numbers, we found that surgical recurrence and quality of life after laparoscopic-assisted and open ileocolic resection were comparable. Incisional hernias occurred only after open ileocolic resection, and laparoscopic-assisted ileocolic resection resulted in a significantly better cosmesis.
Eshuis
Emma J
EJ
Department of Surgery, Academic Medical Centre, G4-146.1, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
Polle
Sebastiaan W
SW
Slors
J Frederik
JF
Hommes
Daan W
DW
Sprangers
Mirjam A G
MA
Gouma
Dirk J
DJ
Bemelman
Willem A
WA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D016009:Chi-Square Distribution; D003082:Colectomy / Q000379:methods; D003424:Crohn Disease / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007079:Ileitis / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012008:Recurrence; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome