title: Endoscopic and clinical recurrences after laparoscopic or open ileocolic resection in Crohn's disease.
abstract: BACKGROUND
  After ileocolic resection in Crohn's disease, studies concerning the influence of the laparoscopic or open approach on clinical and endoscopic recurrences are scarce.
  
  
  METHODS
  In a prospective database, we identified all patients operated on between 2004 and 2012 for primary ileocolic resection in Crohn's disease, with at least 6 months of follow-up. The rates of endoscopic recurrence during the first postoperative year and the clinical recurrence at any time during follow-up were measured and compared after the laparoscopic or open approach.
  
  
  RESULTS
  Sixty-two patients (mean±standard deviation age, 33.5±12.7 years; 35 females) were operated on through laparoscopy (n=28) or laparotomy (n=34). Medical treatment, evolution and phenotype of disease, and postoperative course were comparable in both groups. Mean±standard deviation follow-up was 3.5±1.9 years. Ileocolonoscopy was available in 46 (74.2%) patients. Normal endoscopy or minor recurrence (i0 or i1 grade) was significantly more frequent after laparoscopy (14/24 [58.3%]) versus laparotomy (5/22 [22.7%]) (P=.019). Clinical recurrence was comparable at 1 year (P=.116) and at the end of follow-up (P=.799) after laparoscopy (28.6% and 50%, respectively) or laparotomy (11.8% and 55.9%, respectively).
  
  
  CONCLUSIONS
  After resection, normal or minor endoscopic lesions (i0 or i1 grade) were more frequent after laparoscopy than after laparotomy. However, clinical recurrence was similar after both techniques.
authors.affiliation: 1 Department of General, Digestive, and Endocrine Surgery, University Paris VII Denis-Diderot , Paris, France .
authors.forename: Justine
authors.initials: J
authors.lastname: Bellinger
authors.forename: Nicolas
authors.initials: N
authors.lastname: Munoz-Bongrand
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pariente
authors.forename: Clotilde
authors.initials: C
authors.lastname: Baudry
authors.forename: Mircea
authors.initials: M
authors.lastname: Chirica
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Gornet
authors.forename: Matthieu
authors.initials: M
authors.lastname: Allez
authors.forename: Pierre
authors.initials: P
authors.lastname: Cattan
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D003424:Crohn Disease / Q000601:surgery*; D016208:Databases, Factual; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult