Abstract
Background: The objective of this study was to compare laparoscopic-assisted ileocolic resection for Crohn’s disease of the distal ileum with open surgery in two consecutive groups of patients.
Methods: From 1995 until 1998, 48 patients underwent open ileocolic resection at the Academic Medical Center (AMC) in Amsterdam, while 30 patients had laparoscopic-assisted ileocolic resection at the Leiden University Medical Center (LUMC). Patient characteristics, perioperative course, and recovery were compared. Differences between the groups were tested using Student’s t-test for independent groups and chisquare tests when appropriate.
Results: The open and the laparoscopic patient groups were comparable for age, gender, body mass index (BMI), prior abdominal surgery, and length of resected bowel. The conversion rate was 6.6%. Laparoscopic operating times (138±SD 36 min) were significantly longer than those observed in the open group (104±SD 34 min). Discharge was significantly earlier in the laparoscopic group than the open group (5.7 vs 10.2 postoperative days, p<0.007). Postoperative morbidity did not differ significantly between the patients treated traditionally (14.6%) and laparoscopically (10%).
Conclusion: Compared to open surgery, laparoscopic ileocolic resection for Crohn’s disease is associated with similar morbidity rates, a shorter hospital stay, and improved cosmetic results, justifying the laparoscopic approach as the procedure of choice.
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References
Bauer JJ, Harris MT, Grumbach NM, Gorfine SR (1995) Laparoscopic-assisted intestinal resection for Crohn’s disease. Dis Colon Rectum 38: 712–715
Bemelman WA, van der Made WJ, Mulder EJ, Ringers J, van Hogezand RA (1997) Laparoscopy in Crohn’s disease. Neth J Med 50: S190-S22 DOI: 10.1016/S0300-2977(96)00067-8
Borley NR, Mortensen NJ, Jewell DP (1997) Preventing postoperative recurrence of Crohn’s disease. Br J Surg 84: 1493–1502
Cirocco WC, Schwartzman A, Golub RW (1994) Abdominal wall recurrence after laparoscopic colectomy for colon cancer. Surgery 116: 842–846
Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA (1998) Quality of life, cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12: 1334–1340 DOI: 10.1007/s004649900851
Ferreira MR, Bennett CL, Stryker SJ, Adams J, Beart RW Jr (1997) The learning curve for laparoscopic colorectal surgery: preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomies. Arch Surg 132: 41–44
Fleshman JW, Fry RD, Birnbaum EH, Kodner IJ (1996) Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcome. Dis Colon Rectum 39: 15–22
Hildebrandt U, Pistorius G, Lindemann W, Kreissler-Haag D, Ecker KW (1995) Laparoskopische Resektionen bei Morbus Crohn. Chirurg 66: 807–812
Lehnert T (1998) Laparoscopic resection of colorectal cancer-high art or access artistry. Eur J Surg Oncol 24: 7–8
Liu CD, Rolandelli R, Ashley SW, Evans B, Shin M, McFadden DW (1995) Laparoscopic surgery for inflammatory bowel disease. Am Surg 61: 1054–1056
Ludwig KA, Milsom JW, Church JM, Fazio VW (1996) Preliminary experience with laparoscopic intestinal surgery for Crohn’s disease. Am J Surg 171: 52–56
Milsom JW, Lavery IC, Bohm B, Fazio VW (1993) Laparoscopically assisted ileocolectomy in Crohn’s disease. Surg Laparosc Endosc 3: 77–80
Nduka CC, Monson JRT, Menzies-Gow N, Darzi A (1994) Abdominal wall metastases following laparoscopy. Br J Surg 81: 648–652
Ramos JM, Gupta S, Anthone GJ, Ortega AE, Simons AJ, Beart RW (1994) Laparoscopy and colon cancer: is the port site at risk? a preliminary report. Arch Surg 129: 897–899
Reissman P, Cohen S, Weiss EG, Wexner SD (1996) Laparoscopic colorectal surgery: ascending the learning curve. World J Surg 20: 277–281 DOI: 10.1007/s002689900044
Reissman P, Salky BA, Pfeifer J, Edye M, Jagelman DG, Wexner SD (1996) Laparoscopic surgery in the management of inflammatory bowel disease. Am J Surg 171: 47–51
Senagore AJ, Luchtefeld MA, Mackeigan JM (1995) What is the learning curve for laparoscopic colectomy? Am Surg 61: 681–685
Simons AJ, Anthone GJ, Ortega AE, Franklin M, Fleshman J, Geis WP, Beart RW (1995) Laparoscopic-assisted colectomy learning curve. Dis Colon Rectum 38: 600–603
Wexner SD, Cohen SM (1995) Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82: 295–298
Wu JS, Birnhaum EH, Kodner IJ, Fry RD, Read TE, Fleshman JW (1997) Laparoscopic-assisted ileocolic resections in patients with Crohn’s disease: are abscesses, phlegmons, or recurrent disease contraindications? Surgery 122: 682–689
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Online publication: 13 June 2000
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Bemelman, W.A., Slors, J.F.M., Dunker, M.S. et al. Laparoscopic-assisted vs open ileocolic resection for Crohn’s disease. Surg Endosc 14, 721–725 (2000). https://doi.org/10.1007/s004640000186
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DOI: https://doi.org/10.1007/s004640000186