Hand-assisted laparoscopic surgery for Inflammatory Bowel Disease: Short-term outcomes in 376 patients

2009 ◽  
Vol 15 ◽  
pp. S21
Author(s):  
S Holubar ◽  
R Pendlimari ◽  
J Pattan-arun ◽  
D Larson ◽  
E Dozois ◽  
...  
2012 ◽  
Vol 2012 ◽  
pp. 1-20 ◽  
Author(s):  
Emile Rijcken ◽  
Rudolf Mennigen ◽  
Norbert Senninger ◽  
Matthias Bruewer

Background. Single Port Laparoscopic Surgery (SPLS) is being increasingly employed in colorectal surgery for benign and malignant diseases. The particular role for SPLS in inflammatory bowel disease (IBD) has not been determined yet. In this review article we summarize technical aspects and short term results of SPLS resections in patients with Crohn's disease or ulcerative colitis.Methods. A systematic review of the literature until January 2012 was performed. Publications were assessed for operative techniques, equipment, surgical results, hospital stay, and readmissions.Results. 34 articles, published between 2010 and 2012, were identified reporting on 301 patients with IBD that underwent surgical treatment in SPLS technique. Surgical procedures included ileocolic resections, sigmoid resections, colectomies with end ileostomy or ileorectal anastomosis, and restorative proctocolectomies with ileum-pouch reconstruction. There was a wide variety in the surgical technique and the employed equipment. The overall complication profile was similar to reports on standard laparoscopic surgery in IBD.Conclusions. In experienced hands, single port laparoscopic surgery appears to be feasible and safe for the surgical treatment of selected patients with IBD. However, evidence from prospective randomized trials is required in order to clarify whether there is a further benefit apart from the avoidance of additional trocar incisions.


Gut ◽  
2012 ◽  
Vol 62 (3) ◽  
pp. 387-394 ◽  
Author(s):  
Matti Waterman ◽  
Wei Xu ◽  
Amreen Dinani ◽  
A Hillary Steinhart ◽  
Kenneth Croitoru ◽  
...  

2019 ◽  
Vol 156 (6) ◽  
pp. S-877
Author(s):  
Karolina Pudilova ◽  
Dana Duricova ◽  
Martin Kolar ◽  
Karin Malickova ◽  
Veronika Hruba ◽  
...  

Author(s):  
María José Casanova ◽  
María Chaparro ◽  
Miguel Mínguez ◽  
Elena Ricart ◽  
Carlos Taxonera ◽  
...  

Abstract Background The effectiveness of the switch to another anti–tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8–3; P < 0.0001) and ulcerative colitis vs Crohn’s disease (HR, 1.6; 95% CI, 1.1–2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response.


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