Laparoscopic-assisted versus open ileocolic resection for Crohn's disease : A randomized trial

• Published in: Annals of surgery Vol. 243; no. 2; pp. 143 - 149
• Main Authors: MAARTENSE, Stefan, DUNKER, Mich S, SLORS, J. Frederik M, CUESTA, Miguel A, PIERIK, Erik G. J. M, GOUMA, Dirk J, HOMMES, Daan W, SPRANGERS, Miriam A, BEMELMAN, Willem A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.02.2006
• Subjects: Adolescent; Adult; Biological and medical sciences; Chi-Square Distribution; Crohn Disease - surgery; Digestive System Surgical Procedures - methods; Digestive system. Abdomen; Endoscopy; Female; General aspects; Hospital Costs; Humans; Ileum; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Length of Stay - statistics & numerical data; Male; Medical sciences; Middle Aged; Netherlands; Postoperative Complications; Prospective Studies; Quality of Life; Statistics, Nonparametric; Treatment Outcome; Netherlands; Resection; Laparoscopy; Inflammatory disease; Medicine; Crohn disease; Randomization; Treatment; Surgery; Digestive diseases; Intestinal disease; Clinical trial; Endoscopy; Comparative study
• DOI: 10.1097/01.sla.0000197318.37459.ec
• ISSN: 0003-4932

The aim of the study was to compare laparoscopic-assisted and open ileocolic resection for primary Crohn's disease in a randomized controlled trial. Sixty patients were randomized for laparoscopic-assisted or open surgery. Primary outcome parameter was postoperative quality of life (QoL) during 3 months of follow-up, measured by SF-36 and GIQLI questionnaire. Secondary parameters were operating time, morbidity, hospital stay, postoperative morphine requirement, pain, and costs. Patient characteristics were not different. Conversion rate was 10% (n=3). Median operating time was longer in laparoscopic compared with open surgery (115 versus 90 minutes; P<0.003). Hospital stay was shorter in the laparoscopic group (5 versus 7 days; P=0.008). The number of patients with postoperative morbidity within the first 30 days differed between the laparoscopic and open group (10% versus 33%; P=0.028). There was no statistically significant difference in QoL between the groups during follow-up. Significant time effects were found on all scales of the SF-36 (P<0.001) and the GIQLI score (P<0.001). QoL declined in the first week, returned to baseline levels after 2 weeks, and was improved 4 weeks and 3 months after surgery. Median overall costs during the 3 months follow-up were significantly different: euro6412 for laparoscopic and euro8196 for open surgery (P=0.042). Although QoL measured by SF-36 and GIQLI questionnaires was not different for laparoscopic-assisted compared with the open ileocolic resection, morbidity, hospital stay, and costs were significantly lower.