Laparoscopic colectomy for Crohn's colitis. A large prospective comparative study.
BACKGROUND
The purpose of this study was to compare short-term outcomes of laparoscopic (LC) vs open colectomy (OC) in patients with Crohn's colitis.


METHODS
We collected data on all patients undergoing colectomy for primary or recurrent Crohn's disease confined to the colon from July 2002 to August 2008. Patient and disease-specific characteristics and perioperative and short-term postoperative outcomes were prospectively collected and analyzed.


RESULTS
A total of 125 patients underwent colectomy during the study period, 55 (44%) LC. There were six conversions (10.9%). Median operative time was shorter in the LC group (212 min, interquartile range (IQR) 180-315 LC vs 286 min, IQR 231-387 OC, p = 0.032). Estimated blood loss was less for the LC group (100 ml, IQR 90-250 LC vs 250 ml, IQR 100-400 OC, p = 0.002). Earlier return of bowel function was noted in the LC group (3 days vs 4 days, OC). Length of post-op stay was shorter in the LC group (6 days, IQR 5-8 vs 8 days, IQR 6-10 OC, p = 0.001). There was one death in the OC group. Postoperative complications occurred in eight (14.5%) LC patients vs 16 (22.9%) OC. Disease recurrence rate was 16%, 10.9% LC and 20% OC, respectively.


CONCLUSIONS
Laparoscopic colectomy is a safe and effective technique in the hands of experienced surgeons. Benefits of laparoscopic colectomy in Crohn's disease include reduced operative blood loss, quicker return of bowel function, and shorter hospital length of stay.
Umanskiy
Konstantin
K
Department of Surgery, MC 5095, University of Chicago Hospitals, 5841 S Maryland Avenue, Chicago, IL 60637, USA. kumanskiy@surgery.bsd.uchicago.edu
Malhotra
Gautam
G
Chase
Ayana
A
Rubin
Michele A
MA
Hurst
Roger D
RD
Fichera
Alessandro
A
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D016009:Chi-Square Distribution; D003082:Colectomy / Q000379:methods*; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome