N Siddiqi, Mr, S Zeidan, Mr, M Odermatt, Mr, K Flashman, Ms, J Khan, Mr, A Parvaiz, Professor
Queen Alexandra Hospital
Aim:
Redo surgery in Crohn’s patients is always a challenge to surgeons due to adhesions and distorted anatomy. Laparoscopic resection of primary ileocolic Crohn’s has shown favorable outcomes. We aimed to analyze our database to see if the same results can be achieved in patients presenting with recurrent Crohn’s disease.
Methods:
Prospectively collected data from consecutive patients undergoing laparoscopic surgery for primary and redo Crohn’s between October 2006 and August 2012 were included. Patient demographics, body mass index (BMI), conversions, length of stay (LOS), major morbidity, mortality and 30-day re-admission were analyzed.
Results:
Primary Resection |
Re-do Resection | |||
| n | % | n | % | |
| Total | 72 | 19 | ||
| Male | 28 | 38.9% | 11 | 58.9% |
| Age (Median) Years | 35 (18 – 86) | 50 (21 – 83) | ||
| ASA 3 or 4 | 10 | 13.9% | 2 | 10.5% |
| BMI | 23 (16 – 37) | 25 (18 – 37) | ||
| Converted to Open | 1 | 1.4% | 0 | 0% |
| Elective | 58 | 80.6% | 18 | 94.7% |
| Emergency | 14 | 19.4% | 1 | 5.3% |
| Median Operating Time (min) | 130 (60 – 350) | 180 (90 – 240) | ||
| Median LOS days | 5 (2 – 35) | 5 (3 – 31) | ||
| Readmission < 31 days | 9 | 12.1% | 4 | 21.1% |
| Reoperation < 31 days | 3 | 4.2% | 1 | 5.3% |
| 30 Day Mortality | 0 | 0 | 0 | |
Redo group had older patients and required longer operating time. Higher readmission rate was seen in redo group as well. There was no mortality in either groups and major morbidity was similar. None of these differences were statistically significant. One patient in each group developed anastomotic leak. Two patients in the primary group were re-operated (laparoscopy) for obstruction and unexplained abdominal pain.
Conclusion:
Laparoscopic surgery for redo-ileocolic Crohn’s disease seems feasible with favorable short-term clinical outcomes. A randomized controlled trial will be required to clearly document the added advantage of laparoscopic surgery in this group of patients.
Session: Poster Presentation
Program Number: P118
