Laparoscopic Versus Open Ileo-Colonic Resection in Crohn’s Disease: Short- and Long-Term Results from a Prospective Longitudinal Study

• Published in: Journal of gastrointestinal surgery Vol. 12; no. 6; pp. 1094 - 1102
• Main Authors: Sica, Giuseppe S., Iaculli, Edoardo, Benavoli, Domenico, Biancone, Livia, Calabrese, Emma, Onali, Sara, Gaspari, Achille L
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2008; Springer Nature B.V
• Subjects: Adolescent; Adult; Capsule Endoscopy; Clinical trials; Colectomy - methods; Crohn Disease - diagnosis; Crohn Disease - surgery; Disease; Elective Surgical Procedures; Female; Follow-Up Studies; Gastroenterology; Humans; Ileum - surgery; Laparoscopy - methods; Laparotomy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Original Article; Prospective Studies; Quality of Life; Severity of Illness Index; Surgery; Time Factors; Treatment Outcome; Crohn’s disease surgery; Recurrence; Laparoscopic surgery; Quality of life
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-007-0394-6

Possible relations between surgical approaches, frequency, and severity of Crohn’s disease recurrence after ileo-colonic resection is unknown. We aimed to assess perioperative outcomes and postsurgical complications of laparoscopic versus standard open surgery and to detect differences between the two groups in endoscopical recurrence and patients’ satisfaction. Twenty-eight consecutive patients undergoing elective ileo-colonic resection by either laparoscopic approach ( n  = 15) or conventional open surgery ( n  = 13) were prospectively enrolled. No mortality or major intraoperative complications were observed in both groups. Significant differences between groups were the median operating time found shorter in the open group than in the laparoscopic group ( p  = 0.003), the higher dosage of pain killers needed in the open group ( p  = 0.05), the passage of flatus and\or stool after surgery found faster in group A ( p  = 0.004) and the shorter recovery period in the laparoscopic group ( p  = 0.007). Colonoscopy was performed in 27 patients. The frequency and pattern of recurrence did not differ between the two groups ( p  = 0.63). Patients’ satisfaction was significantly in favor of laparoscopy. Present findings support the feasibility and advantages in the short-term of laparoscopic ileo-colonic resection in patients with Crohn’s disease. No differences were observed in terms of frequency, time of onset, and severity of recurrence in a 1-year follow-up.