Original ResearchLaparoscopic resection for primary and recurrent Crohn's disease: AÂ case series of over 100 consecutive cases

- Laparoscopic resection surgery for Crohn's disease is safe and feasible.
- In the hands of experienced laparoscopic surgeons conversion rates are minimal (4.7% in our series).
- Laparoscopic surgery is a viable option for patients having recurrent or emergency resection surgery for Crohn's disease.

BackgroundLaparoscopic surgery for patients with Crohn's disease (CD) is considered challenging. The aim of this study is to evaluate the clinical outcomes of laparoscopic bowel resection in patients with CD. We also assessed the effectiveness of the laparoscopic approach in recurrent or emergency surgery due to CD.Materials and methodsAll patients with CD, who underwent laparoscopic resection surgery in two units from October 2006 to February 2016, were identified through prospectively maintained databases. Their baseline characteristics and perioperative outcomes were analysed. The outcomes of patients receiving primary vs recurrent and elective vs emergency laparoscopic resections for CD were also examined.ResultsIn total 106 patients underwent laparoscopic resection. Primary ileocolic resection was the most frequent procedure (62%) followed by redo-ileocolic resection (15%). Overall conversion rate was 4.7%, median operative time was 130 (95-185) minutes and length of stay was 4 days (3-6). There was one anastomotic leak (1.1%) and 30-day re-operation rate was 5.7%. Patients having primary resections were younger and had a shorter length of stay (4 vs 5 days; p = 0.014). Thirty day re-operation rate was higher in patients having emergency surgery (3.1% vs 30%; p = 0.011).ConclusionsThis case series demonstrates that laparoscopic resection surgery for CD is safe and feasible. Similarly, laparoscopic surgery is also a viable option for patients having recurrent resection and possibly even emergency surgery.