Single-incision laparoscopic surgery for ileocolic resection in Crohn's disease.
BACKGROUND
Single-incision laparoscopic surgery is a development in the field of minimally invasive surgery that is being increasingly used for colorectal procedures.


OBJECTIVE
We report on the short-term results of single-port laparoscopic ileocolic resection in patients with ileocecal Crohn's disease.


METHODS
This investigation is a retrospective matched-pair control study. Data were obtained from a prospectively maintained single-institution inflammatory bowel disease database.


METHODS
This study was conducted at a tertiary care university hospital.


METHODS
Twenty consecutive patients receiving elective single-port ileocolic resection between April 2010 and May 2011 were included (6 male, 14 female; age, 31.6 ± 10.8 years; BMI, 21.5 ± 2.6 kg/m). Their data were compared with the data of 20 individually matched patients who had undergone standard 3-trocar laparoscopic-assisted ileocolic resection between 2007 and 2010 (6 male, 14 female; age, 31.7 ± 10.7 years; BMI, 21.2 ± 2.5 kg/m). All patients had medically refractory stenosis of the terminal ileum in histologically confirmed Crohn's disease.


METHODS
Single-port laparoscopic-assisted or standard laparoscopic-assisted ileocolic resection was performed.


METHODS
The primary outcomes measured were the surgical details and early outcome.


RESULTS
: The mean length of the paraumbilical single-port incision was 3.8 cm (range, 2.5-5.0 cm). Conversion rates were similar in both groups (1/20 vs 2/20, p = 0.55). Additional strictureplasties or short-segment small-bowel resections were performed in both groups. The overall complication rate was 20% (4/20) in both groups. There were no observed differences in postoperative pain scores and hospital stay duration.


CONCLUSIONS
The limitations of this study were as follows: this study was a comparison of 2 different time points with possible selection bias, there was no prestudy power calculation, and the study might be underpowered.


CONCLUSIONS
Single-port ileocolic resection is a safe procedure for the surgical treatment of stenotizing Crohn's disease of the terminal ileum. Avoidance of additional trocars was the only identified benefit.
Department of General and Visceral Surgery, Muenster University Hospital, Waldeyerstrasse 1, Muenster, Germany. rijcken@uni-muenster.de
Emile
E
Rijcken
Rudolf
R
Mennigen
Ioannis
I
Argyris
Norbert
N
Senninger
Matthias
M
Bruewer
D000328:Adult; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D003092:Colitis / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007079:Ileitis / Q000601:surgery; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome