Laparoscopically assisted ileocolectomy in patients with Crohn's disease: a study of 50 consecutive patients.
BACKGROUND
This study aimed to assess the feasibility, safety, and immediate postoperative outcome of laparoscopically assisted ileocolic resection for Crohn's disease.


METHODS
Data were collected retrospectively from a database of 50 consecutive patients with Crohn's disease who underwent ileocolic resection between 1997 and 2007. The mean age of the patients was 40 years (range, 20-74 years), and 21 of the patients were men. Of the 50 patients, 18 had a history of abdominal surgery. The mean time from diagnosis to operation was 6.4 years (range, 1-31 years). The indications for surgery included subobstruction (48%), failure of medical treatment (20%), and internal fistulas (32%).


RESULTS
The mean operating time was 150 min (range, 80-360 min), and the blood loss was 130 ml (0-400 ml). Only 1 of the 50 patients underwent conversion to laparotomy. Return of bowel movement occurred at a mean of 3 days (range, 1-7 days). The median hospital stay was 8 days (range, 5-130 days). There was no 30-day mortality. The minor complication rate was 20%. The complications included wound infection, pneumonia, urinary infection, postoperative bleeding, prolonged ileus, and fever of unknown origin. Major complications occurred for four patients, with three patients experiencing an anastomotic leak and one patient a leak after fistulectomy.


CONCLUSIONS
The laparoscopically assisted approach to ileocolic Crohn's disease seems to be feasible and safe, with acceptable immediate postoperative outcomes.
Vangeenberghe
Nathalie
N
Department of Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussel, Belgium. nvgeenbe@hotmail.com
De Vogelaere
Kristel
K
Haentjens
Patrick
P
Delvaux
Georges
G
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic; D003082:Colectomy / Q000379:methods*; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D001747:Urinary Bladder Fistula / Q000209:etiology / Q000601:surgery; D055815:Young Adult