Published online Oct 27, 2021. doi: 10.4240/wjgs.v13.i10.1190
Peer-review started: May 7, 2021
First decision: June 6, 2021
Revised: July 9, 2021
Accepted: September 7, 2021
Article in press: September 7, 2021
Published online: October 27, 2021
Along with the unceasing progress of medicine, Crohn's disease (CD), especially complex CD, is no longer a taboo for minimally invasive surgery. However, considering its special disease characteristics, more clinical trials are needed to confirm the safety and feasibility of laparoscopic surgery for CD.
Although laparoscopic ileocolonic for CD is proved to be beneficial, for complex or recurrent CD, more minimally invasive surgical techniques need to be explored and applicated in laparoscopic surgery.
To investigate the safety and feasibility of laparoscopic enterectomy for CD, and to explore minimally invasive surgical techniques in complex CD.
This study prospectively collected clinical data from patients with CD who underwent enterectomy from January 2017 to January 2020. Patients were divided into a laparoscopy group and a traditional laparotomy group according to the surgical method. The baseline characteristics, operative and pathologic data, and short-term (30-d) outcomes were compared between the two groups.
A total of 120 eligible patients were enrolled into the pre-standardized groups, including 100 in the laparoscopy group and 20 in the laparotomy group. Compared with the laparotomy group, the patients in the laparoscopy group recovered more quickly, but had fewer postoperative complications.
Laparoscopic enterectomy combined with varieties of minimally invasive surgical techniques could promote the recovery of patients with CD.
The inflammatory properties of CD lead to a certain particularity and complexity of the intraperitoneal anatomy, making it subject to numerous changes. It requires surgeons not only to have rich CD treatment experience in open surgery, but also advanced laparoscopic surgical skills. Most importantly, if the abdominal cavity is found to contain severe adhesions, the procedure should be transferred to laparotomy in a timely manner to avoid collateral damage, bleeding, infections, and other complications.