演題

Long-term outcome of laparoscopic surgery for recurrent Crohn's disease

[演者] 長谷川 博俊:1
[著者] 岡林 剛史:1, 鶴田 雅士:1, 山田 暢:1, 北川 雄光:1
1:慶應義塾大学一般・消化器外科

Background: Patients with Crohn's disease often require repeated surgical treatments, and the re-operation rate is reported as approximately 40% within 10 years. There is a lack of data on laparoscopic surgery for recurrent Crohn's disease. This study aimed to evaluate the short- and long-term outcomes of recurrent Crohn's disease after laparoscopic surgery compared to open surgery.Method: Between September 1998 and December 2008, 44 patients underwent laparoscopic resection (LR), and 45 patients underwent open resection (OR). The endpoints of this study were defined as the rates of postoperative complications and recurrence requiring further operation. The covariates associated with these outcomes were assessed by univariate and multivariate analyses.Results: Twenty-seven patients developed complications postoperatively, and no significant difference was identified between the two groups (LR group 24.4% vs OR group 28.9%; p = 0.722). The median follow-up period was 42.0 (interquartile range = 55.1 [8.6-63.7]) months. Five patients developed recurrent disease requiring surgery in each group. The 5-year recurrence-free rate in the LR group was not inferior to that in the OR group (LR group 96.6% vs OR group 88.1%; p = 0.722). Multivariate analysis demonstrated that laparoscopic surgery was not associated with the development of recurrent disease (hazard ratio = 1.314 [0.316-5.462], p = 0.707).Conclusion: Laparoscopic surgery for recurrent Crohn's disease was not associated with postoperative complications and recurrence requiring further surgery. Given the advantages of postoperative recovery time and cosmesis, the application of laparoscopy should be seriously considered in patients with recurrent Crohn's disease.
詳細検索
アプリバナー iPhone版,iPad版 Android版