Laparoscopic Redo Ileocolic Resection for Crohn’s Disease in Patients with Previous Multiple Laparotomies

Purposes: Over 80% of patients with primary ileocolic Crohn’s disease have a surgical resection within 10 years of diagnosis, and 40%–50% of them need further surgery within 15 years. Laparoscopic surgery can be challenging due to a thickened mesentery and the potential for fistulas, abscesses, and phlegmons. Aim of this study is to analyze the short-term outcomes of laparoscopic redo ileocolic resections for Crohn’s disease in patients with previous multiple laparotomies. Methods: All patients undergoing laparoscopic surgery for ileocolic Crohn’s disease from March 2006 to February 2017 were prospectively evaluated. Short term outcomes of laparoscopic ileocolic resection were compared between patients with previous multiple major surgeries and recurrent Crohn’s disease, and patients undergoing surgery for the first presentation of Crohn’s disease and no history of previous surgery. Conversion rate and 30-day morbidity were the primary outcomes. Reoperations, readmissions, operating time and length of stay were the secondary outcomes. Results: 29 patients with recurrent Crohn’s disease and previous multiple laparotomies were included: the number of laparotomies these patients previously underwent was 2 in 19 cases (65.5%), 3 in 9 (31%), and 4 in 1 (3.5%). In total, 90 patients with no history of any previous abdominal surgery, who underwent laparoscopic ileocecal resection for Crohn’s disease, represented the control group. No differences were found in morbidity and conversion rate. Operating time was longer in patients with history of previous abdominal surgery. Conclusion: Laparoscopic redo ileocolic resection for Crohn’s disease is feasible and safe in patients with previous multiple laparotomies at the expense of longer operating time.

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Single Port Laparoscopic Surgery for Complex Crohn's Disease Is Safe with a Lower Conversion Rate

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2016.0567 ◽

2017 ◽

Vol 27 (11) ◽

pp. 1095-1100 ◽

Cited By ~ 2

Author(s):

Cosimo Alex Leo ◽

Sanjeev F. Samaranayake ◽

Pramodh C. Chandrasinghe ◽

Irshad A. Shaikh ◽

Jonathan D. Hodgkinson ◽

...

Keyword(s):

Crohn’S Disease ◽

Laparoscopic Surgery ◽

Crohn's Disease ◽

Conversion Rate ◽

Single Port

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Short-term outcomes of laparoscopic surgery for Crohn’s disease patients treated with anti-tumor necrosis factor alpha agents

Surgery Today ◽

10.1007/s00595-016-1375-8 ◽

2016 ◽

Vol 47 (3) ◽

pp. 320-327 ◽

Cited By ~ 1

Author(s):

Tsuyoshi Hata ◽

Tsunekazu Mizushima ◽

Hideki Osawa ◽

Hidekazu Takahashi ◽

Naotsugu Haraguchi ◽

...

Keyword(s):

Crohn’S Disease ◽

Laparoscopic Surgery ◽

Tumor Necrosis Factor ◽

Crohn's Disease ◽

Tumor Necrosis Factor Alpha ◽

Tumor Necrosis ◽

Short Term ◽

Necrosis Factor Alpha ◽

Factor Alpha ◽

Necrosis Factor

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Short-Term Outcomes after Laparoscopic Ileocolic Resection for Crohn’s Disease

Digestive Surgery ◽

10.1159/000097950 ◽

2006 ◽

Vol 23 (5-6) ◽

pp. 346-357 ◽

Cited By ~ 42

Author(s):

Sebastiaan W. Polle ◽

Jan Wind ◽

Dirk T. Ubbink ◽

Daan W. Hommes ◽

Dirk J. Gouma ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Ileocolic Resection ◽

Short Term

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Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis

World Journal of Gastroenterology ◽

10.3748/wjg.v27.i41.7159 ◽

2021 ◽

Vol 27 (41) ◽

pp. 7159-7172

Author(s):

Shin Jeong Pak ◽

Young Il Kim ◽

Yong Sik Yoon ◽

Jong Lyul Lee ◽

Jung Bok Lee ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Propensity Score ◽

Propensity Score Matching ◽

Ileocolic Resection ◽

Long Term Outcomes ◽

Short Term ◽

Propensity Score Matching Analysis

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Safety, feasibility, and short-term outcomes of laparoscopically assisted primary ileocolic resection for Crohn’s disease

Surgical Endoscopy ◽

10.1007/s00464-008-0308-z ◽

2009 ◽

Vol 23 (8) ◽

pp. 1876-1881 ◽

Cited By ~ 38

Author(s):

Mattias Soop ◽

David W. Larson ◽

Kishore Malireddy ◽

Robert R. Cima ◽

Tonia M. Young-Fadok ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Ileocolic Resection ◽

Short Term

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The feasibility and short-term clinical outcomes of single-incision laparoscopic surgery for patients with complex Crohn’s disease

Surgery Today ◽

10.1007/s00595-017-1581-z ◽

2017 ◽

Vol 48 (2) ◽

pp. 242-247 ◽

Cited By ~ 3

Author(s):

Kiyoshi Maeda ◽

Hisashi Nagahara ◽

Masatsune Shibutani ◽

Tatsunari Fukuoka ◽

Shigetomi Nakao ◽

...

Keyword(s):

Crohn’S Disease ◽

Laparoscopic Surgery ◽

Crohn's Disease ◽

Clinical Outcomes ◽

Single Incision ◽

Single Incision Laparoscopic Surgery ◽

Short Term

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Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis

International Journal of Colorectal Disease ◽

10.1007/s00384-020-03821-6 ◽

2020 ◽

Author(s):

Valerio Celentano ◽

◽

Gianluca Pellino ◽

Matteo Rottoli ◽

Francesco Colombo ◽

...

Keyword(s):

Crohn’S Disease ◽

Laparoscopic Surgery ◽

Crohn's Disease ◽

Propensity Score ◽

Hospital Stay ◽

Open Surgery ◽

Single Incision ◽

Length Of Hospital Stay ◽

Single Incision Laparoscopic Surgery ◽

Ileocolic Resection

Abstract Introduction Single-incision laparoscopic surgery (SILS) aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single site, potentially offering better cosmetic results and decreased postoperative pain. In this study, we compare the results of SILS ileocolic resection for Crohn’s disease (CD) to conventional laparoscopy and open surgery using a propensity score–matched analysis in a retrospective national multicentre study. Methods All consecutive patients undergoing elective SILS ileocaecal or redo ileocolic resection for primary and recurrent CD from 1 June 2018 to 31 May 2019 were included. Patients were matched 1:1:1 with laparoscopy and open surgery according to perianal disease, recurrent disease, penetrating phenotype of CD, history of previous abdominal surgery, preoperative medical treatment with steroids and anti-TNF. Postoperative morbidity within 30 days of surgery was the primary endpoint. Results Fifty-eight patients were included in each group, for a total of 174 patients. The conversion rate for SILS and laparoscopy was 10.3% and 12%, respectively, with no difference in the incidence of postoperative complications (13.8% and 12%, p = 0.77), whilst open surgery demonstrated a worse morbidity profile, with a complication rate of 25.9% (p < 0.0001). Median length of hospital stay following SILS ileocolic resection was 5 days, significantly shorter compared to 7 days for laparoscopy and 9 for open surgery (p < 0.0001). Conclusions SILS ileocolonic resection for CD demonstrated a comparable morbidity profile compared to laparoscopy in selected patients, with a reduced length of postoperative hospital stay.

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Role of ultrasound in reducing complication during primary trocar insertion in laparoscopic surgery: prospective observational study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182875 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2747

Author(s):

Vandana Dhama ◽

Vipin Dhama ◽

Rachna Chaudhary ◽

Shakun Singh ◽

Saba Aafrin

Keyword(s):

Laparoscopic Surgery ◽

Abdominal Surgery ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Abdominal Cavity ◽

Rectus Sheath ◽

Previous Abdominal Surgery ◽

Slide Test ◽

History Of ◽

Visceral Slide

Background: Patients presenting to Gynecology OPD at LLRM Medical College, Meerut, UP, India for benign laparoscopic surgery from June 2016 to May 2017 were included in the study. A total of 130 women completed the study of which 30 had history of previous abdominal surgery and 100 had no history of previous abdominal surgery. The ability of the visceral slide test to detect periumbilical adhesions was compared with laparoscopic detection of adhesions.Methods: Patients fulfilling inclusion and exclusion criteria and preanaesthetic clearance were subjected to office based Visceral Slide test using high frequency ultrasound probe (7.5 MHz) in the sagittal plane at the level of umbilicus. Distance between the skin and posterior rectus sheath was measured. Diagnostic accuracy of visceral slide test and mean time taken to perform the test was noted.Results: On laparoscopy 4 women had periumbilical adhesions while 24 women in the total sample had adhesions elsewhere in the abdominal cavity. The visceral slide test had a sensitivity of 75%, specificity of 98%, positive predictive value of 75% and negative predictive value of 99%. The diagnostic accuracy of the test is 97%. The median time to perform the examination was 1.69 minutes.Conclusions: The visceral slide technique was convenient and rapid to perform, and reliably identified adhesions in the periumbilical area.

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Short-term complications of wide-lumen stapled anastomosis after ileocolic resection for Crohn’s disease: who is at risk?

Colorectal Disease ◽

10.1111/j.1463-1318.2009.02180.x ◽

2009 ◽

Vol 12 (10Online) ◽

pp. e298-e303 ◽

Cited By ~ 26

Author(s):

S. Riss ◽

C. Bittermann ◽

S. Zandl ◽

I. Kristo ◽

A. Stift ◽

...

Keyword(s):

At Risk ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Stapled Anastomosis ◽

Ileocolic Resection ◽

Short Term

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Infliximab Extends the Duration until the First Surgery in Patients with Crohn’s Disease

BioMed Research International ◽

10.1155/2013/879491 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Aki Sakatani ◽

Mikihiro Fujiya ◽

Takahiro Ito ◽

Yuhei Inaba ◽

Nobuhiro Ueno ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Abdominal Surgery ◽

Univariate Analysis ◽

Female Gender ◽

Infliximab Treatment ◽

Biological Drugs ◽

History Of ◽

Term Basis ◽

Clinical Records

Background/Aims. While biological drugs are useful for relieving the disease activity and preventing abdominal surgery in patients with Crohn’s disease (CD), it is unclear whether the use of biological drugs in CD patients with no history of abdominal surgery is appropriate. We evaluated the effects of infliximab and other factors on extending the duration until the first surgery in CD patients on a long-term basis.Methods. The clinical records of 104 CD patients were retrospectively investigated. The cumulative nonoperation rate until the first surgery was examined with regard to demographic factors and treatments.Results. The 50% nonoperative interval in the 104 CD patients was 107 months. The results of a univariate analysis revealed that a female gender, the colitis type of CD, and the administration of corticosteroids, immunomodulators, or infliximab were factors estimated to improve the cumulative nonoperative rate. A multivariate analysis showed that the colitis type and administration of infliximab were independent factors associated with a prolonged interval until the first surgery in the CD patients with no history of abdominal surgery.Conclusions. This study suggests that infliximab treatment extends the duration until the first surgery in CD patients with no history of abdominal surgery. The early use of infliximab before a patient undergoes abdominal surgery is therefore appropriate.

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