Comparison of the results of laparotomy and laparoscopic surgery in patients with Crohn’s disease

Introduction: Crohn’s disease is an inflammatory bowel disease which may affect different parts of the gastrointestinal tract. Aim: To compare retrospectively the results of laparotomy and laparoscopic surgery performed in patients with Crohn’s disease between January 1, 2005 and October 31, 2012 in the Department of Surgery, University of Szeged, Hungary. Method: Patients were divided into two groups based on the types of surgery; 103 patients underwent laparotomy and 30 patients had laparoscopic surgery programmed. 22 patients had 24 primary acute interventions. Results: The mean age was significantly lower in the laparoscopic surgery group (p = 0.042). The laparoscopic iliocoecal resections have been found significantly shorter than laparotomies (p = 0.033). When iliocoecal resection was performed the operation time was significantly longer (p = 0.033) while hospitalization time (p = 0.025) and intensive care unit treatment time (p<0.001) were shorter and the bowel passage also started earlier in the laparoscopic group as compared to the laparotomy group. Conclusions: Laparoscopic surgery results in smaller surgical trauma, better cosmetic outcome, shorter hospitalization time and not higher complication- and morbidity-rate as well as shorter operation time in certain cases. However, it requires more qualified surgical team and the operation expenses are higher. Orv. Hetil., 2014, 155(1), 24–29.

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P336 Minimally invasive surgery is safe and feasible for luminal Crohn’s disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.465 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S323-S324

Author(s):

M Nnaji ◽

Y F Chin ◽

O Pujji ◽

B Wilkinson ◽

S Mohan ◽

...

Keyword(s):

Crohn’S Disease ◽

Minimally Invasive Surgery ◽

Laparoscopic Surgery ◽

Crohn's Disease ◽

Open Surgery ◽

Surgical Intervention ◽

Laparoscopic Group ◽

Readmission Rates ◽

Inflammatory Bowel ◽

Reoperation Rates

Abstract Background Crohn’s disease (CD) is an inflammatory bowel condition that still requires surgical intervention in about 70% of cases with laparoscopic surgery increasingly becoming the preferred approach. We present our experience in laparoscopic and open surgery for luminal CD in a DGH setting. Methods This was a retrospective analysis of data collected prospectively between 2008 and 2018. All patients with the diagnosis of CD who underwent a surgical intervention for luminal CD were selected and their demographic, clinical and surgical outcomes data analysed. Results 183 patients were identified. 162 (87%) underwent open and 21 (13%) laparoscopic surgery (p < 0.0001). The median age was 48 years (16–82 years) in the open group and 42 years (16–64 years) in the laparoscopic group(p = 0.05). Male:female ratio was 1:1.2 in the open and 1:1 in the laparoscopic groups. Anastomotic leak rates were lower in the laparoscopic group (0% vs. 2.5%, p = 0.3520). Statistically significant lower readmission rates (9.5% in the laparoscopic, 18% in the open groups, p = 0.0255) and reoperation rates (14% in the laparoscopic and 18% in the open groups, p = 0.0108) were noted in the laparoscopic group. Conclusion Laparoscopic surgery is safe in patients requiring surgical intervention for Crohn’s disease with a notable trend towards improved clinical outcomes.

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P382 Application of enhanced recovery after surgery in single-port laparoscopic partial small intestine resection in the treatment of Crohn’s disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.511 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S357-S357

Author(s):

Y LI ◽

Z Zhou ◽

D Yao ◽

L Zheng ◽

Y Duan ◽

...

Keyword(s):

Crohn’S Disease ◽

Laparoscopic Surgery ◽

Crohn's Disease ◽

Hospital Stay ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Operation Time ◽

Postoperative Hospital Stay ◽

Control Group ◽

Single Incision Laparoscopic Surgery

Abstract Background Single-incision laparoscopic surgery (SILS) with enhanced recovery after surgery (ERAS) can reduce operation trauma and accelerate postoperative rehabilitation. This study aims to investigate the safety and feasibility of SILS with ERAS in the treatment of Crohn’s disease. Methods Thirty patients with Crohn’s disease were randomly assigned to receive traditional laparoscopic surgery plus ERAS (n = 20) and SILS plus ERAS (n = 18)，respectively. Comparisons and analysis were made between the two groups in the perioperative conditions. Results There were significant differences in the mean operation time between the two groups (p < 0.01)，There were no significant differences in the intra-operative blood loss, postoperative complications rates, the time to first flatus and treatment cost (p > 0.05). There were significant differences in the postoperative hospital stay between the two groups (p < 0.05). WBC, CRP and PCT in SILS plus ERAS group were lower than those in the control group at the first days and the third days after operation, the differences were statistically significant (p < 0.05). Conclusion SILS plus ERAS can shorten postoperative hospital stay and facilitate bowel function recovery in the treatment of Crohn’s disease. It is worthwhile to mention the nice cosmetic benefits of SILS, the perioperative SILS plus ERAS program is safe and effective and should be popularised in Crohn’s disease.

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