title: Single-incision laparoscopic ileocecectomy in children with Crohn's disease.
abstract: BACKGROUND
  We previously reported our experience with standard laparoscopic ileocecectomy, but we have recently used a single-incision laparoscopic approach.
  
  
  METHODS
  We conducted a retrospective review of a single surgeon's experience from 2009 to 2013.
  
  
  RESULTS
  Twenty-eight children 11-18 years of age (mean, 15.5 years) with a mean body mass index of 18.9±3 kg/m(2) underwent single-incision laparoscopic ileocecectomy for Crohn's disease. Mean operative time was 86.5±25.9 minutes (range, 56-166 minutes). There were no extra ports placed or conversions to open surgery. Five children (18%) were on parenteral nutrition at time of surgery, 14 (50%) were on steroids, and 9 (32%) were on tumor necrotic factor inhibitors. A stapled extracorporeal anastomosis was performed in all children. Complications included abscess (n=4), small bowel obstruction (n=3), superficial wound infection (n=3), and small bowel perforation (n=1). Some patients had more than one complication. Of those with complications, 5 (56%) were on steroids, 5 (56%) were on tumor necrotic factor inhibitors, and 1 patient was on both. The perforation occurred at a point of adhesiolysis also involved with Crohn's disease. There were no anastomotic leaks. Median follow-up was 17 months (range, 1-47 months).
  
  
  CONCLUSIONS
  Single-incision laparoscopic ileocecectomy is safe and feasible in pediatric patients with Crohn's disease.
authors.affiliation: Department of Surgery, The Children's Mercy Hospital , Kansas City, Missouri.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Sharp
authors.forename: Priscilla
authors.initials: P
authors.lastname: Thomas
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
mesh_terms: D000038:Abscess / Q000209:etiology; D000293:Adolescent; D002432:Cecum / Q000601:surgery*; D002648:Child; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology; D007416:Intestinal Perforation / Q000209:etiology; D007421:Intestine, Small; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology