Laparoscopic surgery for recurrent ileocolic Crohn's disease

Stefan D. Holubar, Eric Dozois, Antonio Privitera, Robert R. Cima, John H. Pemberton, Tonia Young-Fadok, David Larson

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Laparoscopic (LAP) surgery is increasingly performed for primary ileocolic Crohn's disease (CD), but its application in patients with recurrent ileocolic CD is less well described. Our aim was to assess whether or not a laparoscopic approach was safe, feasible, and conferred meaningful short-term benefits in this patient population. Methods: Patients undergoing LAP surgery for recurrent ileocolic CD at our institution from 1998-2008 were identified using a prospectively maintained database. Potential risk factors for conversion to open surgery and overall patient outcomes were assessed with univariate analysis. Results: Forty patients were identified, of which 30 (75%) were LAP-completed and 10 (25%) were LAP-converted. The groups did not differ with respect to clinicopathological features. LAP-converted patients were significantly more likely to require adhesiolysis than LAP-completed patients (100% versus 67%, P = 0.04). There was 1 intraoperative complication in a converted patient. LAP-converted patients had longer times to soft diet (4 versus 3 days, P = 0.03) and longer length of stay (7 versus 4 days, P = 0.003). The groups did not differ with respect to incidence of postoperative complications or frequency of readmission within 30 days. There was no mortality. Concusions: In up to 20% of patients with recurrent ileocolic, successful laparoscopic re-resection may be prevented by adhesions. Conversion increased the length of stay without increasing morbidity. We conclude that LAP surgery can be safely performed in selected patients with recurrent ileocolic CD and leads to short-term benefits.

Original languageEnglish (US)
Pages (from-to)1382-1386
Number of pages5
JournalInflammatory Bowel Diseases
Volume16
Issue number8
DOIs
StatePublished - 2010

Fingerprint

Crohn Disease
Laparoscopy
Length of Stay
Conversion to Open Surgery
Intraoperative Complications
Databases
Diet
Morbidity
Mortality
Incidence

Keywords

  • Crohn's disease
  • Ileocolectomy
  • Laparoscopic
  • Recurrent
  • Reoperative

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Holubar, S. D., Dozois, E., Privitera, A., Cima, R. R., Pemberton, J. H., Young-Fadok, T., & Larson, D. (2010). Laparoscopic surgery for recurrent ileocolic Crohn's disease. Inflammatory Bowel Diseases, 16(8), 1382-1386. https://doi.org/10.1002/ibd.21186

Laparoscopic surgery for recurrent ileocolic Crohn's disease. / Holubar, Stefan D.; Dozois, Eric; Privitera, Antonio; Cima, Robert R.; Pemberton, John H.; Young-Fadok, Tonia; Larson, David.

In: Inflammatory Bowel Diseases, Vol. 16, No. 8, 2010, p. 1382-1386.

Research output: Contribution to journalArticle

Holubar, SD, Dozois, E, Privitera, A, Cima, RR, Pemberton, JH, Young-Fadok, T & Larson, D 2010, 'Laparoscopic surgery for recurrent ileocolic Crohn's disease', Inflammatory Bowel Diseases, vol. 16, no. 8, pp. 1382-1386. https://doi.org/10.1002/ibd.21186
Holubar SD, Dozois E, Privitera A, Cima RR, Pemberton JH, Young-Fadok T et al. Laparoscopic surgery for recurrent ileocolic Crohn's disease. Inflammatory Bowel Diseases. 2010;16(8):1382-1386. https://doi.org/10.1002/ibd.21186
Holubar, Stefan D. ; Dozois, Eric ; Privitera, Antonio ; Cima, Robert R. ; Pemberton, John H. ; Young-Fadok, Tonia ; Larson, David. / Laparoscopic surgery for recurrent ileocolic Crohn's disease. In: Inflammatory Bowel Diseases. 2010 ; Vol. 16, No. 8. pp. 1382-1386.
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