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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2015; 21(40): 11312-11320
Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11312
Minimally invasive surgery for paediatric inflammatory bowel disease: Personal experience and literature review
Alessio Pini-Prato, Maria Grazia Faticato, Arrigo Barabino, Serena Arrigo, Paolo Gandullia, Cinzia Mazzola, Nicola Disma, Giovanni Montobbio, Girolamo Mattioli
Alessio Pini-Prato, Maria Grazia Faticato, Arrigo Barabino, Serena Arrigo, Paolo Gandullia, Cinzia Mazzola, Nicola Disma, Giovanni Montobbio, Girolamo Mattioli, Istituto Giannina Gaslini, 16100 Genoa, Italy
Maria Grazia Faticato, Girolamo Mattioli, DINOGMI, University of Genoa, 16100 Genoa, Italy
Author contributions: Pini-Prato A drafted the paper and designed its structure; Faticato MG collected notes and data belonging to our personal series of PIBD and analysed the results; Barabino A contributed in drafting the manuscript with specific regard to gastroenterologist’s point of view; Arrigo S contributed in drafting the manuscript with specific regard to gastroenterologist’s point of view; Gandullia P contributed in drafting the manuscript with specific regard to gastroenterologist’s point of view; Mazzola C contributed in collecting notes and data belonging to our personal series of PIBD as well as in analysing results; Disma N analyzed the data and contributed in statistical analysis; Montobbio G; contributed in reviewing the final version of the paper; Mattioli G reviewed and approved the final version of the paper.
Supported by Italian Ministry of Health Ricerca Corrente.
Conflict-of-interest statement: All Authors declare to have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alessio Pini-Prato, MD, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genova, Italy. alessiopiniprato@ospedale-gaslini.ge.it
Telephone: +39-10-56362217 Fax: +39-10-3462101
Received: April 15, 2015
Peer-review started: April 17, 2015
First decision: May 18, 2015
Revised: June 2, 2015
Accepted: August 29, 2015
Article in press: August 31, 2015
Published online: October 28, 2015
Processing time: 190 Days and 21 Hours
Abstract

The incidence of paediatric inflammatory bowel disease (PIBD) has dramatically increased in the last 20 years. Although first reported in mid 1970s’, diagnostic laparoscopy has started to be routinely adopted in paediatric surgical practice since late 1990s’. Minimally invasive surgery was first limited to diagnostic purposes. After 2002 it was also applied to the radical treatment of PIBD, either Crohn’s disease (CD) or Ulcerative colitis. During the last decade minimally invasive approaches to PIBD have gained popularity and have recently became the “gold standard” for the treatment of such invalidating and troublesome chronic diseases. The authors describe and track the historical evolution of minimally invasive surgery for PIBD and address all available opportunities, including most recent advancements such as robotic surgery, single port approaches and minimally invasive treatment of perianal fistulising CD. A systematic review of all series of PIBD treated with minimally invasive approaches published so far is provided in order to determine the incidence and type of patients’ complications reported up to present days. The authors also describe their experience with minimally invasive surgery for PIBD and will report the results of 104 laparoscopic procedures performed in a series of 61 patients between January 2006 and December 2014.

Keywords: Paediatric inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Laparoscopy; Minimally invasive approach; Complications

Core tip: This review aims at describing the historical evolution of minimally invasive surgery for paediatric inflammatory bowel diseases (PIBD). We will go through all recent technical advancements, provide an overview of our personal experience and perform an extensive systematic review of available data. The series of patients reported so far will be analysed and most relevant issues addressed in details. We do believe that this review will help physicians dealing with PIBDs by reporting and discussing the most advanced surgical opportunities. A special focus on complications and moreover, long-term outcome will help in implementing adequate education for parents.