Laparoscopic assisted surgery for Crohn’s disease an initial experience and results |
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Authors: | Luan Xiaojun E Gross |
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Institution: | (1) Department of Internal Medicine, Tongji Hospital, Tongji Medical University, 430030 Wuhan;(2) Department of First Surgery, Barmbek Hospital, Hamburg, Germany;(3) Present address: Department of Internal Medicine, The First People’s Hospital of Foshan, 528000 Guangdong |
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Abstract: | Summary The inflammatory process associated with Crohn’s disease often makes dissection difficult, even in open surgery. The aim of
this study was to assess the technical feasibility, safety and indication of laparoscopic assisted procedures performed in
patients with Crohn’s disease. Records of patients undergoing surgical operation for Crohn’s disease from 1993 to 1998 at
our hospital were reviewed. Intestinal resection was performed laparoscopically in 24 patients (LAP) and by open technique
in 23 patients (OPEN). No significant differences existed as to age, gender, body-mass-index and previous surgery. In the
laparoscopic group, seven operations (CON) were converted to open laparotomy (29 %) because of large inflammatory mass and/or
fistula. The mean intraoperative blood loss was significantly higher in CON- and OPEN-groups than in LAP-group (P < 0. 01). Major complications occurred only in one patient who underwent laparoscopic assisted high anterior resection. Patients
who underwent laparoscopic operation tolerated p. o. liquids sooner than patients who underwent open surgery (median; 2 vs.
5 day,P < 0. 05). Compared with the CON- and OPEN-groups, patients in LAP-group had lower analgesic requirements (median: 3 vs. 6
and 5 day,P < 0. 01). The median postoperative length of stay was significantly shorter in LAP-group than in OPEN-group (median: 11 vs.
14 day,P < 0. 05). Our study showed that LAP is technically feasible for Crohn’s disease. The preoperative correct diagnosis and selection
of indications are very important, because the laparoscopic mobilization and resection may be difficult or impossible in patients
with large fixed masses, multiple complx fistulas, or recurrent Crohn’sdisease. |
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Keywords: | Crohn’ s disease laparoscopic assisted surgery indication |
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