Crohn Disease of Ileum
Conditions
Keywords
Crohn Disease, Ileocolic resection, Appendectomy, Single-port incision, McBurney, Laparoscopy
Brief summary
Laparoscopic ileocolic resection is the preferred surgical approach for patients with ileocecal Crohn's disease (CD). Objective of this study was to evaluate the efficacy of a minimally invasive gas-less ileocolic resection in complex cases of CD through a Mc Burney incision, in patients who already had a previous appendectomy.
Detailed description
From January 2016 to December 2017, all consecutive CD patients with primary or recurrent complex disease referred for IC resection were evaluated for the study purpose.Complex disease patients presenting McBurney incision for a previous open appendectomy were included in the group of study. This group was compared with a control group of CD patients with the same clinical characteristics of ileocolic disease who underwent standard laparoscopic IC resection, pooled out from the database of IC resections for CD of the Minimally Invasive and Gastrointestinal Surgery Unit of Tor Vergata Hospital, Rome, Italy. Data on demographics, BMI, type and behavior of CD, presence of disease apart from ileocecal site, previous surgery, recurrence, current medical treatment, thickening of the mesentery, preoperative imaging results (MR enterography or small intestine contrast ultrasound), operative time, blood loss, conversion to laparoscopy and conversion to open rates, complications, adherence rate to ERAS protocols and length of hospital stay were collected for the study purpose.
Interventions
Ileocolic resection through McBurney incision
Sponsors
Study design
Eligibility
Inclusion criteria
* diagnosed Crohn's disease * previous appendectomy trough a mcburney incision
Exclusion criteria
* patients with major comorbidities * age\>75 * previous midline laparotomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean operative time | 75-156 minutes | duration of surgical procedure |
| Mean blood loss during surgical procedure | 2 hours | blood loss from the beginning to the end of the procedure |
| Mean post-operative hospital stay | 3-7 days | time from day of surgery to discharge |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| post-operative complications | 30 days | complications according to Clavien Dindo classification |