Laparoscopic Surgery linked to better outcomes in complicated Crohn's disease, finds study

Laparoscopic surgery is associated with reduced operative times and length of stay in matched cohorts having complicated Crohn's disease. The study was published in the "International Journal of Colorectal Disease." 

Crohn's disease (CD) is a chronic autoimmune disease of the intestinal tract affecting millions of people worldwide. It is a huge burden on the healthcare system and reduces the quality of life of the affected individuals. Among the various treatment options available, Laparoscopic surgery is one of them and it is technically challenging in complicated CD. Research in the past compared heterogeneous cohorts of patients undergoing laparoscopic vs open surgery. Hence researchers from Cleveland, U.S.A conducted a study to compare perioperative and long-term outcomes of matched patients undergoing laparoscopic and open colonic and ileocolonic resection. 

The study was performed on Laparoscopic and open CD patients who were 1:1 propensity scores matched on age, body mass index, sex, indication, ASA grade, prior abdominal surgery, and postoperative Crohn's medication use based on the laparoscopic approach.  

Results: 

• 906 patients underwent surgery for complex CD.
• After propensity matching, 386 were analyzed of which 193 were open and 193 laps.
• Among these 51.3% were male with mean a age of 33.9 + / − 12.6.
• Mean follow-up was 9.8 (range 7.9–12.1) years.
• Length of stay (LOS) and operative time were shorter in the laparoscopic group.
• There was no difference in other complications or mortality.
• After adjusting for postoperative medications, no association was found between the operative approach and subsequent intra-abdominal operation or incisional hernia repair.
• Laparoscopic patients were less likely to have postoperative sepsis. 

Thus, researchers concluded that in matched cohorts having complicated Crohn's laparoscopic surgery is associated with reduced operative times and LOS. Even though mortality, reoperation, and symptomatic hernia rates were equivalent to open surgery the researchers additionally added that postoperative sepsis was less likely to be experienced by laparoscopic patients. 

For the full article, click here: https://doi.org/10.1007/s00384-022-04218-3 

Connelly, T.M., Clancy, C., Duraes, L. et al. Laparoscopic surgery for complex Crohn's disease: perioperative and long-term results from a propensity matched cohort. Int J Colorectal Dis (2022).