Long-term outcomes of laparoscopic versus open ileocolic resection for Crohn's disease: follow-up of a prospective randomized trial.
BACKGROUND
The purpose of this study was to analyze long-term recurrence rates and complications in patients previously enrolled in a prospective randomized trial comparing laparoscopic (LC) and open ileocolectomy (OC) for ileocolic Crohn's disease (CD).


METHODS
Follow-up data were available on 56 of 60 patients. Demographic data, recurrence rates, need for additional surgery related to primary procedure, and medication use were recorded.


RESULTS
Mean follow-up for 56 patients (27 LC vs 29 OC) was 10.5 years and comparable between LC and OC (10.0 vs 11.0, respectively; P = .64). One patient died 8 years after OC of causes unrelated to CD. Eight patients for each group underwent initial reoperative (26% LC vs 28% OC; P = .89). One patient underwent incisional hernia repair after LC (4%) versus 4 patients (14%) after OC (P = .61). Two patients in the LC group underwent adhesiolysis versus none after OC (P = .23). Incidences of anorectal disease, anorectal surgery, endoscopic or radiologic recurrence, and medication use were also similar between LC and OC. OC patients requiring operation during follow-up were significantly more likely than LC to require multiple operations (P = .006).


CONCLUSIONS
Long-term data from this prospective randomized trial confirm that LC is at least comparable to OC in the treatment of ileocolic CD.
Stocchi
Luca
L
Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH 44195, USA. stocchl@ccf.org
Milsom
Jeffrey W
JW
Fazio
Victor W
VW
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003424:Crohn Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome