Current status of laparoscopic surgery for patients with Crohn’s disease

• Published in: International journal of colorectal disease Vol. 28; no. 5; pp. 599 - 610
• Main Authors: Neumann, P. A., Rijcken, E. J. M., Bruewer, M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2013; Springer; Springer Nature B.V
• Subjects: Analysis; Crohn Disease - surgery; Gastroenterology; Hepatology; Humans; Internal Medicine; Laparoscopic surgery; Laparoscopy; Laparoscopy - trends; Medicine; Medicine & Public Health; Practice Guidelines as Topic; Proctology; Review; Surgery; Time Factors; Treatment Outcome; Single incision; Laparoscopy; Specimen extraction; Surgery; Crohn’s disease; Ileocolonic resections
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-013-1684-y

Purpose Minimally invasive surgery is increasingly utilized in treatment for refractory or complicated Crohn’s disease, and new developments aim at further reducing the abdominal trauma and improving the outcome. This review evaluates current literature about minimally invasive surgery for patients with Crohn’s disease, latest advances in single-incision surgery, and methods of specimen extraction. Methods Literature was reviewed with focus on the following topics: indications, surgical procedures, conversions, complications, and short- as well as long-term outcomes of laparoscopic compared to open surgery for refractory, complicated, and recurrent Crohn’s disease. Results Short-term benefits such as shorter hospital stay and faster postoperative recovery are accompanied by long-term benefits such as better cosmetic results and lower treatment-associated morbidity. Single-incision surgery and minimally invasive methods of specimen extraction help to further reduce the surgical trauma and are gradually implemented in the treatment. Conclusion In experienced centers, laparoscopic surgery for Crohn’s disease is safe and as feasible as open operations, even for selected cases with operations for complicated or recurrent disease. However, accurate analysis of the data is complicated by the heterogeneity of clinical presentations as well as the variety of performed procedures. Additional long-term data are needed for evaluation of true benefits of the new techniques.