Laparoscopic-assisted ileocolic resection for Crohn's disease.
BACKGROUND
This study reviews our experience with laparoscopic-assisted ileocolic resection in patients with Crohn's disease. The adequacy and safety of this procedure as measured by intraoperative and postoperative complications were evaluated. Special attention was paid to the group in which laparoscopy was not feasible and conversion to laparotomy was necessary.


METHODS
Between 1992 and 2005, 168 laparoscopic-assisted ileocolic resections were performed on 167 patients with Crohn's ileal or ileocolic disease. Follow-up data were complete in 158 patients.


RESULTS
In 38 patients (24%), conversion to laparotomy was necessary. Previous resection was not a predictor of conversion to laparotomy. Average ileal and colonic length of resected specimens was 20.9 cm and 6.5 cm, respectively, in the laparoscopic group, versus 24.9 cm and 10.6 cm in the converted group. Twenty of 120 specimens (16.6%) in the laparoscopic group were found to have margins microscopically positive for active Crohn's disease. None of the 38 specimens in the converted group had positive ileal margins.


CONCLUSIONS
Laparoscopic-assisted ileocolic resection can be safely performed in patients with Crohn's disease ileitis. The finding of positive surgical margins following laparoscopic resections compared with none among conventional resections has to be thoroughly evaluated.
Edden
Yair
Y
The Mount Sinai School of Medicine, Division of Colon and Rectal Surgery, Department of Surgery, New York, New York, USA.
Ciardullo
Julie
J
Sherafgan
Kashaf
K
Harris
Michael T
MT
Bub
David S
DS
Gorfine
Stephen R
SR
Bauer
Joel J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged