title: Single-incision laparoscopic surgery (SILS) for children with Crohn's disease.
abstract: OBJECTIVE
  Single-incision laparoscopic surgery (SILS) has been described in adults with Crohn's disease, but its use in pediatric Crohn's patients has been limited. The purpose of this study was to review our experience with SILS in pediatric patients with Crohn's disease.
  
  
  METHODS
  A retrospective review was performed for patients diagnosed with Crohn's disease who underwent small bowel resection or ileocecectomy at a freestanding children's hospital from 2006 to 2014. Data collected included demographic data, interval from diagnosis to surgery, operative time, length of stay, and postoperative outcomes.
  
  
  RESULTS
  Analysis identified 19 patients who underwent open surgery (OS) and 41 patients who underwent SILS. One patient (2.4 %) within the SILS group required conversion to OS. Demographic characteristics were similar between the 2 cohorts. The most common indication for surgery was stricture/obstruction (SILS 70.7 % vs. OS 68.4 %, p = 0.86), and ileocecectomy was the most common primary procedure performed (SILS 90.2 % vs. OS 100 % OS). Operative times were longer for SILS (135 ± 50 vs. 105 ± 37 min, p = 0.02). However, when the last 20 SILS cases were compared to all OS cases, the difference was no longer statistically significant (SILS 123.3 ± 34.2 vs. OS 105 ± 36.5, p = 0.12). No difference was noted in postoperative length of stay (SILS 6.5 ± 2.2 days vs. OS 7.4 ± 2.2 days, p = 0.16) or overall complication rate (SILS 24.4 % vs. OS 26.3 %, p = 0.16).
  
  
  CONCLUSIONS
  SILS ileocecectomy is feasible in pediatric patients with Crohn's disease, achieving outcomes similar to OS. As experience increased, operative times also became comparable.
authors.affiliation: Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. justin.huntington@osumc.edu.|Department of Surgery, The Ohio State University Wexner Medical Center, 395 W 10th Ave, Columbus, OH, 43210, USA. justin.huntington@osumc.edu.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Huntington
authors.affiliation: Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Boomer
authors.affiliation: Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Victoria K
authors.initials: VK
authors.lastname: Pepper
authors.affiliation: Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Diefenbach
authors.affiliation: Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Dotson
authors.affiliation: Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
authors.forename: Benedict C
authors.initials: BC
authors.lastname: Nwomeh
mesh_terms: D000293:Adolescent; D002432:Cecum / Q000601:surgery; D002648:Child; D003424:Crohn Disease / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies
keywords: Crohn’s; Ileocecectomy; SILS; Single incision