Can Laparoscopic Ileocolic Resection be Performed with Comparable Safety to Open Surgery for Regional Enteritis: Data from National Surgical Quality Improvement Program

Laparoscopic ileocolic resection is feasible for Crohn's disease but few studies adjust for the various preoperative, intraoperative, and postoperative variables that may confound comparisons with open surgery. The aim of this study is to compare outcomes after laparoscopic (LICR) and open ileocolic resection (OICR) performed for regional enteritis using National Surgical Quality Improvement Program (NSQIP) data. Retrospective evaluation of data prospectively accrued into the NSQIP database for patients undergoing ileocolic resection for Crohn's by LICR and OICR was performed. LICR (n = 104) and OICR (n = 203) groups had similar age (P = 0.1), body mass index (P = 0.9), smoking history (P = 0.6), steroid use (P = 0.7), diabetes (P = 0.3), serum albumin (P = 0.07), and American Society of Anesthesiologists class (P = 0.13). LICR group had more female patients (P = 0.005). Complications including surgical site infections (P = 0.5), wound dehiscence (P = 1), pneumonia (P = 0.1), deep vein thrombosis (P = 0.3), pulmonary embolism (P = 1), urinary infection (P = 0.1), and return to the operating room (P = 0.2) were similar. LICR had shorter length of hospital stay than OICR (P < 0.001). In current practice, as observed with the NSQIP data, LICR, performed by experienced surgeons, is comparable in safety to OICR and is associated with a shorter hospital stay.

[1]  S. Steele,et al.  National Trends and Outcomes for the Surgical Therapy of Ileocolonic Crohn’s Disease: A Population-Based Analysis of Laparoscopic vs. Open Approaches , 2009, Journal of Gastrointestinal Surgery.

[2]  T. Young‐Fadok,et al.  Advantages of laparoscopic resection for ileocolic Crohn’s disease , 2001, Surgical Endoscopy.

[3]  D. Gouma,et al.  Laparoscopic-assisted vs open ileocolic resection for Crohn’s disease , 2000, Surgical Endoscopy.

[4]  P. Tekkis,et al.  The effect of smoking after surgery for Crohn’s disease: a meta-analysis of observational studies , 2008, International Journal of Colorectal Disease.

[5]  D. Gouma,et al.  Long-Term Surgical Recurrence, Morbidity, Quality of Life, and Body Image of Laparoscopic-Assisted vs. Open Ileocolic Resection for Crohn’s Disease: A Comparative Study , 2008, Diseases of the colon and rectum.

[6]  A. Gaspari,et al.  Laparoscopic Versus Open Ileo-Colonic Resection in Crohn’s Disease: Short- and Long-Term Results from a Prospective Longitudinal Study , 2008, Journal of Gastrointestinal Surgery.

[7]  A. Fichera,et al.  Laparoscopy or conventional open surgery for patients with ileocolonic Crohn's disease? A prospective study. , 2007, Surgery.

[8]  D. Gouma,et al.  Short-Term Outcomes after Laparoscopic Ileocolic Resection for Crohn’s Disease , 2007, Digestive Surgery.

[9]  D. Gouma,et al.  Laparoscopic-Assisted Versus Open Ileocolic Resection for Crohn's Disease: A Randomized Trial , 2006, Annals of surgery.

[10]  A. Darzi,et al.  Comparison of laparoscopic and open ileocecal resection for Crohn’s disease: a metaanalysis , 2006, Surgical Endoscopy And Other Interventional Techniques.

[11]  A. Rosman,et al.  Metaanalysis of trials comparing laparoscopic and open surgery for Crohn’s disease , 2005, Surgical Endoscopy And Other Interventional Techniques.

[12]  M. Solomon,et al.  Laparoscopic versus open ileocolic resection for Crohn's disease. , 2004, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[13]  R. Bergamaschi,et al.  Comparison of Conventional and Laparoscopic Ileocolic Resection for Crohn’s Disease , 2003, Diseases of the colon and rectum.

[14]  R. Baldassano,et al.  Laparoscopic-assisted bowel resection offers advantages over open surgery for treatment of segmental Crohn's disease in children. , 2003, Journal of pediatric surgery.

[15]  S. Vickers,et al.  Laparoscopic vs conventional ileocolectomy for primary Crohn disease. , 2003, Archives of surgery.

[16]  C. Matuchansky,et al.  Laparoscopic ileocecal resection in Crohn’s disease , 2003, Surgical Endoscopy And Other Interventional Techniques.

[17]  Conor P. Delaney,et al.  Advantages of Laparoscopic Resection for Ileocecal Crohn’s Disease , 2002, Diseases of the colon and rectum.

[18]  J. Langer,et al.  Laparoscopic-Assisted Versus Open Ileocolic Resection for Adolescent Crohn Disease , 2001, Journal of pediatric gastroenterology and nutrition.

[19]  S. Msika,et al.  Can laparoscopy reduce hospital stay in the treatment of crohn's disease? , 2001, Diseases of the colon and rectum.

[20]  V. Fazio,et al.  Prospective, randomized trial comparing laparoscopicvs. conventional surgery for refractory ileocolic crohn's disease , 2001, Diseases of the colon and rectum.

[21]  E. Weiss,et al.  Comparison of laparoscopically assisted and conventional ileocolic resection for Crohn's disease. , 2000, The European journal of surgery = Acta chirurgica.

[22]  Teresa C. Horan,et al.  Guideline for Prevention of Surgical Site Infection, 1999 , 1999, Infection Control &#x0026; Hospital Epidemiology.

[23]  F. Grover,et al.  The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. , 1998, Annals of surgery.