Comparison of laparoscopic and open ileocecal resection for Crohn’s disease in children

• Published in: Pediatric surgery international Vol. 39; no. 1; p. 140
• Main Authors: Dotlacil, V., Lerchova, T., Coufal, S., Kucerova, B., Schwarz, J., Hradsky, O., Skaba, R., Rygl, M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 27.02.2023; Springer Nature B.V
• Subjects: Abdomen; Body mass index; Catheters; Child; Crohn Disease - surgery; Crohns disease; Female; Fistula; Hospitalization; Hospitals; Humans; Laparoscopy; Length of stay; Medicine; Medicine & Public Health; Original; Original Article; Patients; Pediatric Surgery; Pediatrics; Postoperative Complications - epidemiology; Software; Surgery; Surgical anastomosis; Variables; Paediatric surgery; Laparoscopy; Ileocecal resection; Single-incision laparoscopic surgery; Crohn’s disease
• ISSN: 1437-9813; 0179-0358; 1437-9813
• DOI: 10.1007/s00383-023-05419-9

Purpose Ileocecal resection (ICR) is the most frequently performed surgery in paediatric Crohn’s disease (CD) patients. The aim of the study was to compare laparoscopic-assisted and open ICR. Methods Retrospective review of consecutive CD patients undergoing ICR between March 2014 and December 2021 was performed. The patients were divided into open (OG) and laparoscopic (LG) groups. Compared parameters included patients’ demographics, clinical characteristics, surgery, duration of hospitalisation and follow-up. Complications were classified according to the Clavien–Dindo classification (CDc). Risk factors were identified using multivariable analysis. Results Sixty-two patients (29 females, 46.7%) were included in the analysis, forty-two patients in OG. The median duration of surgery was 130 in OG versus 148 in LG ( p  = 0.065) minutes. Postoperative complications were reported in 4 patients (12.1%). There was no significant difference in postoperative complications according to CDc (OG 7.14 vs LG 5%, p  = 1). The median length of hospitalisation was 8 in OG and 7 days in LG ( p  = 0.0005). The median length of follow-up was 21.5 months. Conclusion The laparoscopic-assisted approach had shorter hospital stay and was not associated with increased risk of 30-day postoperative complications. Laparoscopic surgery should be considered the preferred surgical approach for primary ICR.