Laparoscopic-assisted vs open ileocolic resection for Crohn’s disease

Bemelman, Willem A.; Slors, J. F. M.; Dunker, M. S.; Hogezand, R. A. van; Deventer, S. J. H. Van; Ringers, J.; Griffioen, G.; Gouma, Dirk J.

doi:10.1007/s004640000186

Cited by 108 publications

(130 citation statements)

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“…Patients undergoing restorative proctocolectomy may benefit from a laparoscopic approach, as demonstrated by previous studies comparing laparoscopic procedures with open surgery for inflammatory bowel disease [1][2][3][4]. Whereas these studies reported on resections confined to only small parts of the bowel, proctocolectomy belongs to the most extensive gastrointestinal resections.…”

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confidence: 99%

Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial

et al. 2007

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Background: This study aimed to compare quality of life (QOL), functional outcome, body image, and cosmesis after hand-assisted laparoscopic (LRP) versus open restorative proctocolectomy (ORP). The potential longterm advantages of LRP over ORP remain to be determined. The most likely advantage of LRP is the superior cosmetic result. It is, however, unclear whether the size and location of incisions affect body image and QOL. Methods: In a previously conducted randomized trial comparing LRP with ORP, 60 patients were prospectively evaluated. The primary end points were body image and cosmesis. The secondary end points were morbidity, QOL, and functional outcome. A body image questionnaire was used to evaluate body image and cosmesis. The Short Form-36 Health Survey and the Gastrointestinal Quality of Life Inventory were used to assess QOL. Body image and QOL also were assessed preoperatively.Results: A total of 53 patients completed the QOL and functional outcome questionnaires. There were no differences in functional outcome, morbidity, or QOL between LRP and ORP. At a median of 2.7 years after surgery, 46 patients returned the questionnaires regarding body image, cosmesis, and morbidity. The body image and cosmesis scores of female patients were significantly higher in the LRP group than in the ORP group (body image, 17.4 vs 14.9; cosmesis, 19.1 vs 13.0, respectively). The female patients in the ORP group had significantly lower body image scores than the male patients (14.9 vs 18.3).Conclusions: This study is the first to show that ORP has a negative impact on body image and cosmesis as compared with LRP. Functional outcome, QOL, and morbidity are similar for the two approaches. The advantages of a long-lasting improved body image and cosmesis for this relatively young patient population may compensate for the longer operating times and higher costs, particularly for women.

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confidence: 99%

Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial

et al. 2007

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“…Several studies, most of which are case series and small comparative studies, have pointed out the feasibility and safety of minimal invasive surgery for ileocolic Crohn’s disease[2,3,4,5,6,7]. Despite the initial enthusiasm for the laparoscopic approach, only 2 RCTs comparing laparoscopic ileocolic resection (LIR) with conventional open ileocolic resection (CIR) have been conducted since the first reported LIR[ 8, 9].…”

Section: Introductionmentioning

confidence: 99%

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

Polle¹,

Wind²,

Ubbink

et al. 2006

Dig Surg

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Background: No consensus exists whether ileocolic resection for Crohn’s disease (CD) should be carried out by a laparoscopic or open approach. A systematic review was conducted to assess the evidence for short-term advantages of laparoscopic compared to open resection for ileocolic CD. Methods: The literature search was conducted over the period 01/1991 to 02/2006. Only randomized controlled trials (RCTs), clinical controlled trials and comparative studies comparing laparoscopic with open resection for ileocolic CD were included. A quality assessment was performed for all retrieved articles. The main outcome parameters were operating times, conversion rates, major and minor morbidity and hospital stays. Results: 14 publications encompassing 729 patients were included – 2 were RCTs, 12 were non-RCTs of which 2 were case-matched studies. Although pooling data of operating times was statistically not possible, they were longer for the laparoscopic procedure in the individual studies ranging from 75 to 185 min. Conversions varied between 0 and 16.7%. Postoperative complications requiring reoperation or reported overall morbidity were not different (risk difference –0.01 and –0.05, respectively). Hospital stay after the laparoscopic procedure was 1.90 days shorter (95% CI: 0.83–2.97). Conclusion: There is evidence that laparoscopic ileocolic resection for CD is associated with shorter hospital stay compared to open ileocolic resection, while morbidity rates are equal and conversion rates are acceptable

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“…A variety of different studies described a decreased duration of hospitalization of around 1-3 days. [6][7][8]11,13,16,[26][27][28] We analyzed our data to confirm if the length of stay was also shorter in the laparoscopic group.…”

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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Laparoscopic-assisted vs open ileocolic resection for Crohn’s disease

Abstract: Compared to open surgery, laparoscopic ileocolic resection for Crohn's disease is associated with similar morbidity rates, a shorter hospital stay, and improved cosmetic results, justifying the laparoscopic approach as the procedure of choice.

Cited by 108 publications

References 17 publications

Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial

Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial

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

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

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Laparoscopic-assisted vs open ileocolic resection for Crohn’s disease

Abstract: Compared to open surgery, laparoscopic ileocolic resection for Crohn's disease is associated with similar morbidity rates, a shorter hospital stay, and improved cosmetic results, justifying the laparoscopic approach as the procedure of choice.

Cited by 108 publications

References 17 publications

Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial

Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial

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

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

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