TY - JOUR
T1 - Totally Laparoscopic Ileocolic Resection with Intracorporeal Anastomosis for Crohn's Disease
T2 - A Comparative Study
AU - Hazzan, David
AU - Zippel, Douglas
AU - Segev, Lior
N1 - Publisher Copyright:
© 2024 Israel Medical Association. All rights reserved.
PY - 2024/6
Y1 - 2024/6
N2 - Background: Although minimally invasive surgery for Crohn's disease has been validated in previous studies, most of those reports have referred to laparoscopic-assisted procedures with an extra-corporeal anastomosis. Objectives: To evaluate the short- and Long-term outcomes of totally laparoscopic ileocolic resection with an intracorporeal anastomosis for Crohn's disease patients. Methods: We conducted a single-center retrospective review of all patients who underwent primary ileocolic resection for Crohn's disease between 2010 and 2021. Group A included 34 patients who underwent totally laparoscopic ileocolic resection with intracorporeal anastomosis. Group B comprised 144 patients who underwent an open or laparoscopic-assisted procedure. Results: No differences were noted in operative time (mean 167 minutes vs. 152 minutes, P= 0.122), length of stay (median 6.4 days vs. 7.5 days, P = 0,135), readmission rates (11.8% vs. 13.2%, P = 1), and microscopic involvement of surgical margins (7.7% vs. 18.5%, P = 0.249). Group A had significantly fewer postoperative surgical site infections (2.9% vs. 22.2% respectively, P= 0.013), with no differences in other complications prevalence. After a median follow-up of 46 months, there were similar rates of endoscopic recurrence (47.1% vs. 51.4%, P= 0.72), clinical recurrence (35.3% vs. 47.9%, P= 0.253), and surgical recurrence (2.9% vs. 4.9%, P= 0.722). Conclusions: Totally laparoscopic ileocolic resection with intracorporeal anastomosis for Crohn's disease is safe and resulted in favorable outcomes in terms of postoperative wound healing. The long-term disease recurrence rates were like those of laparoscopic-assisted and open ileocolic resection.
AB - Background: Although minimally invasive surgery for Crohn's disease has been validated in previous studies, most of those reports have referred to laparoscopic-assisted procedures with an extra-corporeal anastomosis. Objectives: To evaluate the short- and Long-term outcomes of totally laparoscopic ileocolic resection with an intracorporeal anastomosis for Crohn's disease patients. Methods: We conducted a single-center retrospective review of all patients who underwent primary ileocolic resection for Crohn's disease between 2010 and 2021. Group A included 34 patients who underwent totally laparoscopic ileocolic resection with intracorporeal anastomosis. Group B comprised 144 patients who underwent an open or laparoscopic-assisted procedure. Results: No differences were noted in operative time (mean 167 minutes vs. 152 minutes, P= 0.122), length of stay (median 6.4 days vs. 7.5 days, P = 0,135), readmission rates (11.8% vs. 13.2%, P = 1), and microscopic involvement of surgical margins (7.7% vs. 18.5%, P = 0.249). Group A had significantly fewer postoperative surgical site infections (2.9% vs. 22.2% respectively, P= 0.013), with no differences in other complications prevalence. After a median follow-up of 46 months, there were similar rates of endoscopic recurrence (47.1% vs. 51.4%, P= 0.72), clinical recurrence (35.3% vs. 47.9%, P= 0.253), and surgical recurrence (2.9% vs. 4.9%, P= 0.722). Conclusions: Totally laparoscopic ileocolic resection with intracorporeal anastomosis for Crohn's disease is safe and resulted in favorable outcomes in terms of postoperative wound healing. The long-term disease recurrence rates were like those of laparoscopic-assisted and open ileocolic resection.
KW - Crohn's disease
KW - intracorporeal anastomosis
KW - laparoscopy
UR - http://www.scopus.com/inward/record.url?scp=85196473712&partnerID=8YFLogxK
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C2 - 38884309
AN - SCOPUS:85196473712
SN - 1565-1088
VL - 26
SP - 361
EP - 368
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 6
ER -