title: Long-term outcome of laparoscopic ileocecal resection for Crohn's disease before the era of biologics.
abstract: BACKGROUND
  Crohn's disease (CD) of the terminal ileum not responding to standard medical treatment is more and more treated with biologics instead of surgery. In order to get more information on the results of surgery, we analyzed the outcome of laparoscopic ileocecal resection (LICR) performed before the widespread use of these drugs.
  
  
  METHODS
  Chart reviews and telephone follow-ups were performed on 119 patients treated with laparoscopic ileocecal resection for CD. Follow-ups were performed at a median of 58 (17-124) and 113(69-164) months. Symptomatic restenosis requiring surgery or endoscopic dilatation was the primary endpoint. We further analyzed risk factors of recurrence.
  
  
  RESULTS
  Of the 119 patients initially treated, 18 required surgery (n = 14) or endoscopic dilatation (n = 4). The calculated rates of re-intervention were 10 und 17.5 % at 5 and 10 years, respectively. Ninety percent of the patients had a Crohn-specific medication treatment at the time of surgery, but only 51.4 und 46.9 % at FU 1 und 2, respectively. Smoking increased the risk of recurrence (OR 3.7, P = 0.011).
  
  
  CONCLUSIONS
  The data demonstrate excellent long-term results of LICR for CD of the terminal ileum. Surgery should be considered as a first choice treatment in many patients with ileocecal CD not responding to conventional treatment.
authors.affiliation: Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Leverkusen, Germany, andreas.rink@klinikum-lev.de.
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Rink
authors.forename: Ivo R
authors.initials: IR
authors.lastname: Fischer
authors.forename: Boris
authors.initials: B
authors.lastname: Vestweber
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Vestweber
mesh_terms: D000293:Adolescent; D000328:Adult; D001688:Biological Products / Q000627:therapeutic use*; D002432:Cecum / Q000601:surgery*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007082:Ileum / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001688:Biological Products