Safety, feasibility, and short-term outcomes of laparoscopically assisted primary ileocolic resection for Crohn's disease.
BACKGROUND
Outcomes of laparoscopic resection for ileocecal Crohn's disease have been reported previously in smaller studies, suggesting its short-term advantages over open surgery. This study assessed the safety and recovery parameters in the largest, consecutive, single-institution series to date.


METHODS
Consecutive patients undergoing laparoscopically assisted primary ileocolic resection for Crohn's disease between 1994 and 2006 were identified in an institutional prospectively collected database. Operative and postoperative outcomes at 30 days were studied.


RESULTS
In this study, 109 patients (35 men) with a mean age of 35 +/- 14 years and a mean body mass index (BMI) of 25 +/- 6 kg/m(2) were identified. The main indications for surgery were medically refractory disease (63%) and fibrous stenosis (27%). In 41% of the cases, previous abdominal surgery had been performed. The surgery had a mean duration of 150 +/- 45 min and a conversion rate of 6%. The overall 30-day morbidity rate was 11%, and the reoperation rate was 1%. The mortality rate was 0%. The median postoperative hospital stay was 4 days (range, 2-15 days).


CONCLUSIONS
This series, the largest reported to date, concurs with recent metaanalyses findings that laparoscopically assisted primary ileocecal resection for Crohn's disease is safe and feasible, resulting in better short-terms outcomes than open resection. This operation is therefore the procedure of choice for Crohn's disease at our institutions.
Soop
Mattias
M
Division of Colon and Rectal Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Larson
David W
DW
Malireddy
Kishore
K
Cima
Robert R
RR
Young-Fadok
Tonia M
TM
Dozois
Eric J
EJ
D018784:Abdominal Abscess / Q000209:etiology / Q000601:surgery; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003082:Colectomy / Q000379:methods*; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents