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Canadian Journal of Gastroenterology - Volume 15 2001, Issue 4, Pages 237-242

Original Article

Department of Surgery, St Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada

Department of Gastroenterology, St Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada

Received 10 November 1999; Accepted 18 January 2000

Copyright © 2001 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC http:-creativecommons.org-licenses-by-nc-4.0-, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.

Abstract

BACKGROUND: Laparoscopic bowel resection is an alternative to open surgery for patients with Crohn-s disease requiring surgical resection. The present report describes a seven-year experience with the laparoscopic treatment of Crohn-s disease compared with the open technique in a tertiary Canadian centre.

PATIENTS AND METHODS: A retrospective analysis of 61 consecutive patients undergoing elective resection for Crohn-s disease was carried out between October 1992 and June 1999. This analysis included 32 laparoscopic resections mean age 33 years and 29 open resections mean age 42 years. Patient demographics were compared, as well as short and long term outcomes after surgery mean follow-up 39 months.

RESULTS: Patients in the laparoscopic group were younger and had fewer previous bowel surgeries than patients who had open resections. Indications for surgery and operative times were similar between the groups. Patients who underwent laparoscopic resections required fewer doses of narcotic analgesics. The resumption of bowel function after surgery, and tolerance of a clear liquid and solid diet was quicker in the laparoscopic group. Patients who underwent laparoscopic resections had significantly shorter hospital stays than those who underwent open resections. Fifteen patients 48.4% in the laparoscopic group experienced recurrence of disease compared with 13 patients 44.8% in the open group. In both groups, the most common site of recurrence was at the anastomosis. The disease-free interval was the same length for both groups 23.9±17.3 months for the laparoscopic resection patients compared with 23.9±20.2 months for the open resection patients; P=1.00.

CONCLUSIONS: Laparoscopic resection for Crohn-s disease can be performed safely and effectively. Quicker resumption of oral feeds, less postoperative pain and earlier discharge from hospital are advantages of the laparoscopic method. No differences in the recurrence rate or the disease-free interval were noted.





Autor: Jeanine Tabet, Dennis Hong, Cei-Whan Kim, Jason Wong, Robert Goodacre, and Mehran Anvari

Fuente: https://www.hindawi.com/



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