Comparison of laparoscopic and open ileocecal resection for Crohn’s disease: a metaanalysis

Tilney, H. S.; Constantinides, Vasilis; Heriot, Alexander G.; Nicolaou, Marios; Athanasiou, Thanos; Ziprin, Paul; Darzi, Ara; Tekkis, Paris

doi:10.1007/s00464-005-0500-3

Cited by 176 publications

(114 citation statements)

References 48 publications

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“…e most common indications for surgical resection are refractory disease despite medical therapy or side e ects of medication (steroid dependence) (15,252,253) . Recently, laparoscopic techniques in selected patients have been advantageous in terms of more rapid resolution of postoperative ileus and shortened hospital stay, without increased complications compared with open surgery (252,254,255) . Patients who have active luminal CD and fail to improve within 7 -10 days of intensive in-patient medical management should be considered to be potential surgical candidates.…”

Section: Indications For Surgerymentioning

confidence: 99%

Management of Crohn's Disease in Adults

2009

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Guidelines for clinical practice are intended to suggest preferable approaches to particular medical problems as established by interpretation and collation of scientifi cally valid research, derived from extensive review of published literature. When data that will withstand objective scrutiny are not available, a recommendation may be made based on a consensus of experts. Guidelines are intended to apply to the clinical situation for all physicians without regard to specialty. Guidelines are intended to be fl exible, not necessarily indicating the only acceptable approach, and should be distinguished from standards of care that are infl exible and rarely violated. Given the wide range of choices in any health-care problem, the physician should select the course best suited to the individual patient and the clinical situation presented. These guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee. Expert opinion is solicited from the outset for the document. The quality of evidence upon which a specifi c recommendation is based is as follows: Grade A: Homogeneous evidence from multiple well-designed randomized (therapeutic) or cohort (descriptive) controlled trials, each involving a number of participants to be of suffi cient statistical power. Grade B: Evidence from at least one large well-designed clinical trial with or without randomization, from cohort or case -control analytic studies, or well-designed meta-analysis. Grade C: Evidence based on clinical experience, descriptive studies, or reports of expert committees. The Committee reviews guidelines in depth, with participation from experienced clinicians and others in related fi elds. The fi nal recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scientifi c developments at a later time.

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Section: Indications For Surgerymentioning

confidence: 99%

Management of Crohn's Disease in Adults

2009

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“…Some reports relate that laparoscopic surgery shows lower morbidity and mortality rates, faster recovery of intestinal motility, lower postoperative admission times, lower adherential syndromes and lower rates of incisional hernias (4,(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic ileocecal resection in acute and chronic presentations of Crohn�s disease. A single center experience

Cocorullo¹

2016

GCHIR

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“…The difference between open and laparoscopic resections was also 2 days in these analyses. 9,10,[29][30][31] This could be due to more severe abdominal trauma, more tissue damage, and prolonged intestinal paralysis in open surgery than that of laparoscopic surgery, which is often cited by other authors.…”

Section: Length Of Staymentioning

confidence: 99%

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Hoffmann¹,

Siebrasse²,

Schlöricke³

et al. 2017

OAS

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Aim:To investigate, via data analysis, the long-term outcome of patients who underwent either laparoscopic or open surgery for Crohn's disease. Methods: A total of 113 patients who had undergone first abdominal surgery due to Crohn's disease between January 2000 and December 2010 in a maximum care provider facility, were included in the statistical analysis. All patients provided their informed consent prior to inclusion. Data were collected from a database. Follow-up data included data from central mortality registries, general practitioners and a specialized clinic. Statistical analysis of the general patient data and the different operations and approaches were performed with the use of chi-square test, Fisher's exact test, and the Mann-Whitney U test. Results: The median follow-up period in case of open and laparoscopic surgery was found to be 9 and 6 years, respectively. Statistically significant differences were observed for the following parameters in case of open and laparoscopic surgery, respectively: age (median=44 vs. 36 years, range=15-76 vs. 15-72 years; p=0.007), urgency of operation (23 out of 34 planned vs. 6 out of 70 planned; p<0.001), year of resection (median=2003 vs. 2006, range=2000-2010 vs. 2000-2010; p=0.001). The length of stay in hospital was significantly shorter in the laparoscopic group than that of open surgery group (8 vs. 11 days, respectively; p<0.0001). We did not control for factors such as age and comorbidities in our statistical analysis. We also did not find any differences with regard to perioperative and 90-day mortality, surgical complications, length of specimen, stoma, surgical recurrence rate (10% in both groups) and number of re-admissions. Moreover, we did not find differences between patients with early operation after first symptoms and patients with long course of disease. A statistically significant difference was found for long-term mortality that was higher in the open surgery group than that of laparoscopic group (p=0.005) (the median for open surgery group was significantly higher than that of laparoscopic group). Conclusion: The outcome of laparoscopic and open surgery is at least comparable. Shorter length of hospital stay and comparable surgical recurrence rates are advantages of laparoscopy.

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Comparison of laparoscopic and open ileocecal resection for Crohn’s disease: a metaanalysis

Cited by 176 publications

References 48 publications

Management of Crohn's Disease in Adults

Management of Crohn's Disease in Adults

Laparoscopic ileocecal resection in acute and chronic presentations of Crohn�s disease. A single center experience

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

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Comparison of laparoscopic and open ileocecal resection for Crohn’s disease: a metaanalysis

Cited by 176 publications

References 48 publications

Management of Crohn's Disease in Adults

Management of Crohn's Disease in Adults

Laparoscopic ileocecal resection in acute and chronic presentations of Crohn�s disease. A single center experience

Long-term outcome of laparoscopic and open surgery in patients with Crohn&rsquo;s disease

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Product

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Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease