scholarly journals Minimal Open Access Ileocolic Resection in Complicated Crohn’s Disease of the Terminal Ileum

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Giuseppe S. Sica ◽  
Sara Di Carlo ◽  
Stefano D’Ugo ◽  
Claudio Arcudi ◽  
Leandro Siragusa ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Open Access ◽  
Crohn's Disease ◽  
Operative Time ◽  
Statistical Significance ◽  
Study Group ◽  
Ileocolic Resection ◽  
Operative Costs ◽  
Standard Laparoscopic Surgery

The objective of this study was to evaluate the possibility to undertake an ileocolic resection in complex Crohn’s disease using a minimal open abdominal access using standard laparoscopic instruments. The incision was carried out over the previous McBurney scar, with a mean length of 6 cm. Seventy-two patients with complicated Crohn’s disease underwent IC resection in the considered period; 12 patients had a McBurney scar due to a previous appendectomy and represented the group of study. Feasibility and safety of the procedure were evaluated. Clinical data and outcome were compared with a control arm of 15 patients who had a standard laparoscopic IC resection, pooled out from our database among those who had a McBurney incision as service incision. Mean operative time and postoperative stay were significantly shorter in the study group. Blood loss and operative costs were also lower in the study group but did not reach statistical significance. Minimal open access ileocolic resection (MOAIR) through a small McBurney incision seems safe and feasible in complex Crohn’s disease. Some advantages over standard laparoscopic surgery could be found in surgical outcomes and costs.

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

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.

The Role of Laparoscopic Surgery in Repeat Ileocolic Resection for Crohn’s Disease

2021 ◽  
Author(s):  
Heather Carmichael ◽  
Daniel Peyser ◽  
Vanessa Baratta ◽  
Deepika Bhasin ◽  
Adrienne Dean ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Ileocolic Resection

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

2018 ◽  
Vol 108 (1) ◽  
pp. 42-48 ◽  
Author(s):  
V. Celentano ◽  
F. Sagias ◽  
K. G. Flashman ◽  
J. Conti ◽  
J. Khan
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Abdominal Surgery ◽  
Conversion Rate ◽  
Operating Time ◽  
Ileocolic Resection ◽  
Short Term ◽  
Previous Abdominal Surgery ◽  
History Of

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.

AntiTNF α: Risk Factor of Major Complications Following Ileocolic Resection for Crohn's Disease

2020 ◽  
Author(s):  
Benichou Benjamin ◽  
Rahili Mohamed Amine ◽  
Bernard Jean Louis ◽  
Hébuterne Xavier ◽  
Schneider Stéphane ◽  
...  
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileocolic Resection ◽  
Major Complications

Intracorporeal versus extracorporeal anastomosis for robotic ileocolic resection in Crohn's disease

2021 ◽  
Author(s):  
Giacomo Calini ◽  
Solafah Abdalla ◽  
Mohamed A. Abd El Aziz ◽  
Hamedelneel A. Saeed ◽  
Anne-Lise D. D’Angelo ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileocolic Resection ◽  
Extracorporeal Anastomosis

scholarly journals Anastomotic Ulcers After Ileocolic Resection for Crohn’s Disease Are Common and Predict Recurrence

2019 ◽  
Vol 26 (7) ◽  
pp. 1050-1058 ◽  
Author(s):  
Robert P Hirten ◽  
Ryan C Ungaro ◽  
Daniel Castaneda ◽  
Sarah Lopatin ◽  
Bruce E Sands ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Multivariable Analysis ◽  
Disease Recurrence ◽  
Ileocolic Resection ◽  
Anastomotic Ulcer ◽  
Endoscopic Recurrence ◽  
Academic Center ◽  
Endoscopic Remission ◽  
The Impact

Abstract Background Crohn’s disease recurrence after ileocolic resection is common and graded with the Rutgeerts score. There is controversy whether anastomotic ulcers represent disease recurrence and should be included in the grading system. The aim of this study was to determine the impact of anastomotic ulcers on Crohn’s disease recurrence in patients with prior ileocolic resections. Secondary aims included defining the prevalence of anastomotic ulcers, risk factors for development, and their natural history. Methods We conducted a retrospective cohort study of patients undergoing an ileocolic resection between 2008 and 2017 at a large academic center, with a postoperative colonoscopy assessing the neoterminal ileum and ileocolic anastomosis. The primary outcome was disease recurrence defined as endoscopic recurrence (&gt;5 ulcers in the neoterminal ileum) or need for another ileocolic resection among patients with or without an anastomotic ulcer in endoscopic remission. Results One hundred eighty-two subjects with Crohn’s disease and an ileocolic resection were included. Anastomotic ulcers were present in 95 (52.2%) subjects. No factors were associated with anastomotic ulcer development. One hundred eleven patients were in endoscopic remission on the first postoperative colonoscopy. On multivariable analysis, anastomotic ulcers were associated with disease recurrence (adjusted hazard ratio [aHR] 3.64; 95% CI, 1.21–10.95; P = 0.02). Sixty-six subjects with anastomotic ulcers underwent a second colonoscopy, with 31 patients (79.5%) having persistent ulcers independent of medication escalation. Conclusion Anastomotic ulcers occur in over half of Crohn’s disease patients after ileocolic resection. No factors are associated with their development. They are associated with Crohn’s disease recurrence and are persistent.

Feasibility of laparoscopic surgery for complex Crohn's disease of the small intestine

2016 ◽  
Vol 9 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Tatsuya Manabe ◽  
Takashi Ueki ◽  
Kinuko Nagayoshi ◽  
Taiki Moriyama ◽  
Kosuke Yanai ◽  
...  
Keyword(s):  
Small Intestine ◽  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease

Outcomes of Primary Ileocolic Resection for Pediatric Crohn's Disease in the Biologic Era

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elizabeth A. Spencer ◽  
Lauren Jarchin ◽  
Priya Rolfes ◽  
Sergey Khaitov ◽  
Alexander Greenstein ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileocolic Resection
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