Conclusions
From the data currently available, firm and absolute recommendations cannot be drawn for the use of laparoscopy in the surgical treatment of Crohn’s disease, due to the heterogeneous features of the disease.
For elective ileocolic resections, laparoscopy offers better immediate post-operative results possibly at a lower global cost and with potentially less incidence of small-bowel obstructions due to adhesions in the long-term. For complex disease, laparoscopy can be offered as a trial to all patients. Inflammatory masses, presence of fistulas and reoperation for recurrence are not absolute contraindications for this approach, even though they are the most significant cause of conversion. Pre-operative percutaneous drainage of abscesses together with accurate pre-operative medical therapy can be used to render surgery less demanding. For isolated perianal Crohn’s disease, laparoscopy can be considered the approach of choice for stoma construction.
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References
Gordon P, Nivatvongs S (1999) Principles and practice of surgery for the colon, rectum, and anus. Quality Medical, St. Louis, MO, USA
Milsom JW, Hammerhofer KA, Böhm B et al (2001) Prospective, randomised trial comparing laparoscopic vs. conventional surgery for refractory ileocolic Crohn’s disease. Dis Colon Rectum 44:1–9
Dunker MS, Stiggelbout AM, van Hogezand RA et al (1998) Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 12:1334–1340
Bergamaschi R, Pessaux P, Arnaud JP (2003) Comparison of conventional and laparoscopic ileocolic resection for Crohn’s disease. Dis Colon Rectum 46:1129–1133
Young-Fadok TM, Hall Long K, MvConnell EJ et al (2001) Advantages of laparoscopic resection for ileocolic Crohn’s disease: improved outcomes and reduced costs. Surg Endosc 15:450–454
Bemelman WA, Slors JFM, Dunker MS et al (2000) Laparoscopic assisted vs. open resection for Crohn’s disease: a comparative study. Surg Endosc 14:721–725
Shore G, Gonzalez QH, Bondora A et al (2003) laparoscopic vs. conventional ileocolectomy for primary Crohn’s disease. Arch Surg 138:76–79
Duepree H-J, Senagore AJ, Delaney CP et al (2002) Advantages of laparoscopic resection for ileocecal Crohn’s disease. Dis Colon Rectum 45: 605–610
Watanabe M, Hasegawa H, Yamamoto S et al (2002) Successful application of laparoscopic surgery to the treatment of Crohn’s disease with fistulas. Dis Colon Rectum 45:1057–1061
Evans J, Poritz L, Mac Bade H (2002) Influence of experience on laparoscopic ileocolic resection for Crohn’s disease. Dis Colon Rectum 45:1595–1600
Canin-Endres J, Salky B, Gattorno F et al (1999) Laparoscopically assisted intestinal resection in 88 patients with Crohn’s disease. Surg Endosc 13:595–599
Hasegawa H, Watanabe M, Nishibori H et al (2003) Laparoscopic surgery for recurrent Crohn’s disease. Br J Surg 90:970–973
Hamel CT, Hildebrandt U, Weiss EG et al (2001) Laparoscopic surgery for inflammatory bowel disease. Surg Endosc 15:642–645
Schmidt CM, Talamini M, Kaufman HS et al (2001) Laparoscopic surgery for Crohn’s disease: reasons for conversion. Ann Surg 233:733–739
Reissmann P, Salky BA, Edye M et al (1996) Laparoscopic surgery in Crohn’s disease. Surg Endosc 10:1201–1204
Wexner SD, Moscovitz ID (2000) Laparoscopic colectomy in diverticular and Crohn’s disease. Surg Clin North Am 80:1299–1319
Kishi D, Nezu R, Ito T et al (2000) Laparoscopicassisted surgery for Crohn’s disease: reduced surgical stress following ileocolectomy. Surg Today 30:219–222
Moorthy K, Shaul T, Hons BS et al (2004) Factors that predict conversion in patients undergoing laparoscopic surgery for Crohn’s disease. Am J Surg 187:47–51
Bauer JJ, Harris MT, Grumbach NM et al (1996) Laparoscopic-assisted intestinal resection for Crohn’s disease. J Clin Gastroenterol 23:44–46
Oliveira L, Reissman P, Nogueras J et al (1997) Laparoscopic creation of stomas. Surg Endosc 11:19–23
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D’Annibale, A., Morpurgo, E. (2006). Laparoscopy for the Treatment of Crohn’s Disease. In: Delaini, G.G. (eds) Inflammatory Bowel Disease and Familial Adenomatous Polyposis. Springer, Milano. https://doi.org/10.1007/88-470-0434-9_20
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