Comparison of laparoscopic and open ileocecal resection for Crohn’s disease in children
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In brief
In brief
This retrospective study of 62 pediatric Crohn's disease patients demonstrates that laparoscopic-assisted ileocecal resection achieves comparable complication rates to open surgery while reducing hospital stay by one day. The findings support laparoscopic approach as the preferred technique for primary ileocecal resection in children with Crohn's disease.
Written by the GCMD Library team from the article.
Abstract
Purpose
Ileocecal resection (ICR) is the most frequently performed surgery in paediatric Crohn’s disease (CD) patients. The aim of the study was to compare laparoscopic-assisted and open ICR.
Methods
Retrospective review of consecutive CD patients undergoing ICR between March 2014 and December 2021 was performed. The patients were divided into open (OG) and laparoscopic (LG) groups. Compared parameters included patients’ demographics, clinical characteristics, surgery, duration of hospitalisation and follow-up. Complications were classified according to the Clavien–Dindo classification (CDc). Risk factors were identified using multivariable analysis.
Results
Sixty-two patients (29 females, 46.7%) were included in the analysis, forty-two patients in OG. The median duration of surgery was 130 in OG versus 148 in LG (p = 0.065) minutes. Postoperative complications were reported in 4 patients (12.1%). There was no significant difference in postoperative complications according to CDc (OG 7.14 vs LG 5%, p = 1). The median length of hospitalisation was 8 in OG and 7 days in LG (p = 0.0005). The median length of follow-up was 21.5 months.
Conclusion
The laparoscopic-assisted approach had shorter hospital stay and was not associated with increased risk of 30-day postoperative complications. Laparoscopic surgery should be considered the preferred surgical approach for primary ICR.