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.
Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH 44195, USA. stocchl@ccf.org
Luca
L
Stocchi
Jeffrey W
JW
Milsom
Victor W
VW
Fazio
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