Journal of the anus, rectum and colon · 2025
Short-term Outcomes and Associated Factors of Postoperative Complications following Laparoscopic Ileocecal Resection in Complex Crohn's Disease.
СтатьяНазвание и аннотация: Перевод в очереди
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Nakao Eiichi, Tatsumi Kenji, Obara Nao, Goto Koki, Kuroki Hirosuke, Sugita Akira, Koganei Kazutaka
Аннотация
OBJECTIVES: Minimally invasive surgery (MIS) is widely used for Crohn's disease (CD), but its feasibility in complex CD is still debated. This study aimed to evaluate short-term outcomes and identify factors associated with major complications following laparoscopic ileocecal resection in patients with complex CD.
METHODS: A retrospective study was conducted on patients with complex CD who underwent laparoscopic ileocecal resection. Patients with prior intestinal surgery for CD were excluded to ensure a uniform cohort. Short-term outcomes, including operative time, blood loss, complications, and hospital stay, were compared between patients undergoing laparoscopic (LS) and open surgery (OS). Univariate analysis was performed to assess factors associated with major complications (Clavien-Dindo grade ≥3).
RESULTS: A total of 101 patients were included (LS, n=21; OS, n=80). The LS group had significantly lower blood loss (140 vs. 222.5 mL, P=0.048) and shorter postoperative hospitalization (12 vs. 15 days, P=0.0068). No conversions to open surgery were required. There was no significant difference in the incidence of major complications (9.5% vs. 3.8%, P=0.57). Major complications occurred in 4.8% of cases overall. Univariate analysis showed that both preoperative abscess formation (P=0.048) and increased intraoperative blood loss (P=0.020) were significantly associated with major complications.
DISCUSSION: Our findings support that laparoscopic ileocecal resection is both feasible and beneficial for complex CD, offering reduced blood loss and shorter hospital stays. However, both preoperative abscess formation and increased intraoperative blood loss were significantly associated with major complications, highlighting the importance of meticulous infection control and intraoperative hemostasis.
METHODS: A retrospective study was conducted on patients with complex CD who underwent laparoscopic ileocecal resection. Patients with prior intestinal surgery for CD were excluded to ensure a uniform cohort. Short-term outcomes, including operative time, blood loss, complications, and hospital stay, were compared between patients undergoing laparoscopic (LS) and open surgery (OS). Univariate analysis was performed to assess factors associated with major complications (Clavien-Dindo grade ≥3).
RESULTS: A total of 101 patients were included (LS, n=21; OS, n=80). The LS group had significantly lower blood loss (140 vs. 222.5 mL, P=0.048) and shorter postoperative hospitalization (12 vs. 15 days, P=0.0068). No conversions to open surgery were required. There was no significant difference in the incidence of major complications (9.5% vs. 3.8%, P=0.57). Major complications occurred in 4.8% of cases overall. Univariate analysis showed that both preoperative abscess formation (P=0.048) and increased intraoperative blood loss (P=0.020) were significantly associated with major complications.
DISCUSSION: Our findings support that laparoscopic ileocecal resection is both feasible and beneficial for complex CD, offering reduced blood loss and shorter hospital stays. However, both preoperative abscess formation and increased intraoperative blood loss were significantly associated with major complications, highlighting the importance of meticulous infection control and intraoperative hemostasis.