Laparoscopic-assisted bowel resection offers advantages over open surgery for treatment of segmental Crohn’s disease in children
Section snippets
Materials and methods
All patients who underwent a bowel resection for Crohn’s disease by a single surgeon between March 1997 and March 2002 were identified through operative logs, hospital registration information, and an inflammatory bowel disease registry. A retrospective analysis of the medical records was undertaken to determine the type of operation performed (laparoscopic versus open laparotomy), and the clinical data elements of the study were collected. The primary outcome measure was length of stay
Results
Twenty-eight patients were identified for analysis, 12 in the laparoscopic group and 16 in the open group. The patient’s age, duration of disease, and segments involved were similar in each group (Table 1). The majority of patients in each group underwent resection of the terminal ileum and cecum. The others had segmental resections of the small bowel. Postoperative stay was shorter in the laparoscopic group (LAP; median, 5.5 days; range, 4 to 26) than the open laparotomy group (OPEN; median,
Discussion
Laparoscopic techniques offer a number of potential advantages to patients undergoing bowel resection for Crohn’s disease. Initial uses of laparoscopy were primarily for diagnosis,11, 12 but as laparoscopic skills have advanced, bowel resections are now being done using an incision just large enough to deliver the specimen from the peritoneal cavity. The advantages of the laparoscopic approach are well described and are typical of those seen with other laparoscopic operations. Decreased
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Cited by (54)
Advances in minimally invasive surgery in pediatric patients
2014, Advances in PediatricsLaparoscopy in Crohn's disease
2014, Best Practice and Research: Clinical GastroenterologyCitation Excerpt :Three studies [25,34,56] focused on the topic and, among them, only two [25,34] are comparative. In these two latter studies, the authors highlighted that the benefits of a laparoscopic approach in adults were also observed in a paediatric setting, as they reported a faster bowel function recovery [34] and a shorter length of hospital stay [25,34] after laparoscopic approach, as compared to the open approach. Several surgical techniques regarding laparoscopic ileo-colic resection for Crohn's disease have been described.
Fast-track management is safe and effective after bowel resection in children with Crohn's disease
2014, Journal of Pediatric SurgeryCitation Excerpt :In pediatric patients, the terminal ileum is frequently involved, making ileocecectomy among the most common surgical interventions performed in this population. Laparoscopic-assisted ileocecectomy has been shown to be safe and effective for segmental Crohn's disease in adult [16,17] and pediatric [18–20] patients. Among the most compelling arguments for the introduction of minimally invasive approaches for pediatric Crohn's resection is the associated decrease in length of hospital stay [20].
Crohn's Disease
2012, Pediatric Surgery, 2-Volume Set: Expert Consult - Online and PrintCrohn's Disease
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2010, Ashcraft's Pediatric Surgery