Single-incision laparoscopic surgery for stricturing and penetrating Crohn's disease.
OBJECTIVE
Single-incision laparoscopic surgery (SILS) is a promising new technique that is potentially applicable to Crohn's disease (CD). However, there is no consensus on the application of SILS for penetrating CD due to its complex pathology.


METHODS
We investigated the feasibility of SILS in 24 CD patients (12 with stricturing and 12 with penetrating CD) and compared the results between the two groups.


RESULTS
There were 17 males and seven females [median age at the time of surgery, 41 (range 20-61) years old] included in the study. Sixteen patients underwent primary surgery, while eight received repeat surgery. Twenty patients had small bowel CD and four patients had ileocolonic CD. The indication for surgery was a fistula/abscess in 12 patients, stenosis in 10 and other indications in two cases. The total length of the operation and blood loss was 171 min (113-221 min) and 230 mL (30-400 mL) in the penetrating CD cases, and 149 min (111-186 min) and 90 mL (20-400 mL) in the stricturing CD cases. There were no significant differences in the length of the operation between the two groups, but the blood loss was significantly greater in the cases of penetrating CD. Conversion to open surgery was required in one patient with penetrating CD. Postoperative complications developed in one patient with stricturing CD.


CONCLUSIONS
SILS could be performed safely not only in patients with stricturing CD, but also in those with penetrating CD.
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. tmizushima@gesurg.med.osaka-u.ac.jp.
Tsunekazu
T
Mizushima
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Kiyokazu
K
Nakajima
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Hiroshi
H
Takeyama
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Atsushi
A
Naito
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Hideki
H
Osawa
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Mamoru
M
Uemura
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Junichi
J
Nishimura
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Taishi
T
Hata
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Ichiro
I
Takemasa
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Hirofumi
H
Yamamoto
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Yuichiro
Y
Doki
Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Masaki
M
Mori
D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D003251:Constriction, Pathologic / Q000601:surgery; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult
Penetrating Crohn’s disease; Single-incision laparoscopic surgery; Stricturing Crohn’s disease