Background
Crohn’s patients have been considered challenging laparoscopic candidates. The aim
of this study was to analyze the short-term and long-term outcomes of laparoscopic
and open surgery in consecutive patients with ileocolonic Crohn’s disease.
Methods
Patients were enrolled prospectively but not randomized between August 2002 and October
2006. Patients and disease-specific characteristics, intraoperative variables, and
short-term and long-term postoperative outcomes were analyzed.
Results
Overall, 146 consecutive patients were included in the study: 59 in the laparoscopic
operation group and 87 in the open operation group. Laparoscopic patients were younger
(P = .001), with a lower body mass index (BMI) (P = .008). Operative time was similar between the 2 groups. Blood loss was less in
the laparoscopic group (P = .012), and postoperative blood transfusions were administered only to patients
in the open group. Narcotic requirement, which was expressed as days on the IV narcotics
and as morphine equivalent, was less in the laparoscopic group (P = .01). Duration of stay was less in the laparoscopic group, 5.5 versus 7.0 days,
(P = .001). Using step-wise multiple regression analysis, the use of laparoscopic operation
was associated with a lesser hospital stay (P < .05). Complication rates were similar, which included 1 anastomotic leak that required
reoperation in each group. At a median follow-up of 19 months, there have been no
disease recurrences.
Conclusions
In selected patients, laparoscopy leads to a faster recovery without increasing morbidity
and without compromising remission. It should be considered a safe and effective alternative
to open operation.
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Article info
Publication history
Accepted:
August 18,
2007
Footnotes
Supported by the University of Chicago Cancer Research Foundation (UCCRF) through an Auxiliary Board Research Support Grant (to A.F.).
Identification
Copyright
© 2007 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
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- ErratumSurgeryVol. 143Issue 2
- PreviewAs a result of a production error, several articles appearing in the Central Surgical Association (Surgery, 2007; Vol. 142, No. 4:433-644) and American Association of Endocrine Surgeons (Surgery, 2007; Vol. 142, No. 6:785-1030) special focus issues were published without their respective discussions. The articles affected have now been updated online to include the missing discussion material. Surgery apologizes to the authors for this significant oversight.
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