title: Meta-analysis of laparoscopic surgery for recurrent Crohn's disease.
abstract: OBJECTIVE
  It remains unclear whether laparoscopic surgery is suitable for recurrent Crohn's disease (CD). The objective of this meta-analysis was to evaluate the safety and feasibility of laparoscopic resection for recurrent vs. primary CD by comparing intraoperative and postoperative outcomes.
  
  
  METHODS
  We searched the PubMed and Cochrane Library databases for studies that compared complications associated with laparoscopic resection for primary and recurrent CD. The primary study endpoints were conversion rates and postoperative complication rates.
  
  
  RESULTS
  Seven trials with a collective total of 627 participants (413 with primary CD and 214 with recurrent CD) met our inclusion criteria. Laparoscopic resection was associated with a significantly higher conversion rate when performed for recurrent CD than for primary CD (OR = 2.53; 95 % CI 1.22-5.25; p = 0.01). However, there was no significant difference in the total complication rate between laparoscopic resection for primary vs. that for recurrent CD (OR = 1.41; 95 % CI 0.86-2.34; p = 0.18).
  
  
  CONCLUSIONS
  Although a higher conversion rate suggests technical complexity, laparoscopic resection for recurrent CD is considered a safe and feasible procedure, without an increased risk of postoperative complications.
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Shigeta
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan. okabayashikoji@gmail.com.
authors.forename: Koji
authors.initials: K
authors.lastname: Okabayashi
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Tsuruta
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Seishima
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D003424:Crohn Disease / Q000601:surgery*; D016206:Databases, Bibliographic; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012449:Safety
keywords: Crohn’s disease; Laparoscopic surgery; Meta-analysis; Recurrent