Laparoscopic Surgery for Crohn’s Disease. an experience with more than 300 cases.

Laparoscopic resection for Crohn’s disease has had a slow adoption rate in gastrointestinal surgery. This is not unexpected considering the inflammatory nature of the disease process and the need for reoperative surgery.

This study is a retrospective analysis of a prospective database from one surgeon at the Mount Sinai Hospital, New York, NY.

Since 1993, 333 patients with Crohn’s disease have undergone 343 laparoscopic procedures. The mean age is 37 (range 15-79). There are 183 females and 150 males. Previous surgery was present in 134 patients with 95 having had at least one prior intestinal resection (29%). Steroids or immunosuppressive medications were present in 100 patients (30%). The indication for surgery was intestinal obstruction (244), abdominal pain (53), unclear diagnosis (14), duodenal obstruction (9), abscess (11), and peritonitis (2). Enteric fistulae were present in 110 patients (32%). They mainly consisted of entero-entero (72), ileo-sigmoid (49), and entero-abdominal wall (33) fistulas. The most common procedures were primary ileocolic resection (165), secondary ileocolic resection (65), and small bowel resection (38). There were four conversions in the series (1.2%). The mean length of stay was 3.9 days in the cases completed laparoscopically. There were no mortalities. The overall complication rate was 11%. There were 18 postoperative bowel obstructions, 8 anastamotic leaks, and 4 occurrences of postoperative bleeding. 13 patients required reoperation in the postoperative period.

Laparoscopic resection is a safe and effective operation for Crohn’s disease. This study decribes one of the largest series in published literature.

Session: Podium Presentation

Program Number: S018

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