Laparoscopic Approach in Patients with Recurrent Crohn's Disease

Abstract

The purpose of this study is to review our experience with laparoscopic management of Crohn's disease including patients with prior Crohn's-related abdominal surgery. All cases of Crohn's patients who underwent laparoscopic attempt for management of disease from April 2005 to October 2010 (n = 130) at a single institution were retrospectively reviewed. Evaluated datapoints include: prior abdominal surgery for Crohn's disease, operative time, rate of conversion, and complication rate. Of the 130 patients, 82 (63.1%) patients had no prior abdominal surgery and 48 (36.9%) patients had previous bowel surgery with mean age of 35.3 (3.5–79) and 41.3 (15–66) years, respectively. Operative time with no prior surgery was 106 (23–245) minutes, and with prior surgery was 100 (26–229) minutes. Estimated blood loss with no prior surgery was 116 (5–800) mL, and with prior surgery was 123 (5–800) mL. Conversion from laparoscopic to open surgery in those with no prior surgery was 17.1 per cent and in those with prior surgery, 20.8 per cent ( P = 0.64). Postoperative complications were found in 13 patients (15.9%) without prior abdominal surgery and 13 patients (27.1%) with prior surgery ( P = 0.17). The most common postoperative complication in both groups was infection/abscess (8.5%). The laparoscopic management of recurrent Crohn's disease is a safe and technically feasible option, even in those patients with prior history of Crohn's-related abdominal surgery, with a low complication rate and low conversion rate. The utility of the laparoscopic approach in Crohn's patients faced with repeat abdominal procedures may be beneficial in the long-term and should be considered as a method to limit morbidity.