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Minimally invasive surgery for ileo–colic Crohn's disease
Author(s) -
Motson R. W.,
Kadirkamanathan S. S.,
Gallegos N.
Publication year - 2002
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1046/j.1463-1318.2002.00297.x
Subject(s) - medicine , surgery , crohn's disease , abscess , fistula , disease , laparoscopic surgery , abdominal surgery , laparoscopy
Objective Patients requiring surgery for Crohn's disease are likely to undergo further surgery due to recurrent disease. A prospective study of laparoscopic‐assisted surgery for ileo‐colic Crohn's disease is reported. Method Forty‐one patients (26 female; median age 35 years) with ileo‐colic Crohn's disease, without evidence of either fistula or abscess formation underwent laparoscopic‐assisted surgery. All had medical therapy, including steroids, but had failed to respond or relapsed. Sixteen patients (39%) had previous surgery for Crohn's disease and 26 (63.4%) had previous abdominal surgery. Laparoscopic procedures ( n =42) included ileocaecal/ileocolic resection ( n =39), small bowel resection ( n =1) and strictureplasty ( n =2). Results The median operating time was 90 min (range 60–180). There were 6 conversions (14.6%). Of the 35 patients whose operation was completed laparoscopically, the median postoperative stay was 5 days (3–9) and the median time to full activity was 20 days (7–49). No major complications or death were recorded. The median follow up (34 out of 35) after surgery is 15.3 months (1–55). Twenty‐four patients remain symptom free and 4 have minimal symptoms with no clinical or radiological evidence of recurrence of Crohn's disease. Six have however, developed recurrence requiring medical ( n =5) and surgical ( n =1) treatment. Conclusion Laparoscopic‐assisted surgery for Crohn's disease is feasible. It has the advantage of minimizing hospital stay and promoting early recovery in a group of patients who are likely to have further surgery due to the nature of the disease.