Wan J, Yuan XQ, Wu TQ, Yang MQ, Wu XC, Gao RY, Yin L, Chen CQ. Laparoscopic vs open surgery in ileostomy reversal in Crohn’s disease: A retrospective study. World J Gastrointest Surg 2021; 13(11): 1414-1422 [PMID: 34950430 DOI: 10.4240/wjgs.v13.i11.1414]
Corresponding Author of This Article
Chun-Qiu Chen, MD, Chief Doctor, Center for Difficult and Complicated Abdominal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No. 301 Yanchangzhong Road, Shanghai 200092, China. chenchunqiu6@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
Jian Wan, Xiao-Qi Yuan, Tian-Qi Wu, Mu-Qing Yang, Xiao-Cai Wu, Ren-Yuan Gao, Lu Yin, Chun-Qiu Chen, Center for Difficult and Complicated Abdominal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200092, China
Author contributions: Wan J reviewed the literature and drafted the manuscript; Yuan XQ and Wu TQ contributed to data analysis; Wan J, Yuan XQ, Wu TQ, Yang MQ, Yin L, and Chen CQ performed the surgery; Chen CQ, Wu XC, and Gao RY made revision to the manuscript; all authors have approved the submission of this manuscript.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the Shanghai Tenth People’s Hospital Affiliated to the Tongji University School of Medicine (approval No. 21K53).
Informed consent statement: Given that the research was retrospective, the requirement for informed patient consent was waived.
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Chun-Qiu Chen, MD, Chief Doctor, Center for Difficult and Complicated Abdominal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No. 301 Yanchangzhong Road, Shanghai 200092, China. chenchunqiu6@126.com
Received: April 25, 2021 Peer-review started: April 25, 2021 First decision: July 15, 2021 Revised: July 23, 2021 Accepted: September 8, 2021 Article in press: September 8, 2021 Published online: November 27, 2021
ARTICLE HIGHLIGHTS
Research background
The advantages of minimally invasive surgery for ileostomy reversal (IR) have attracted increasing attention, although relatively few studies have investigated the benefits of IR for patients with Crohn's disease (CD).
Research motivation
It is worthwhile to evaluate the potential benefits and risks of laparoscopy for patients with CD.
Research objectives
To compare the safety, feasibility, and short-term and long-term outcomes of laparoscopic IR (LIR) vs open IR (OIR) for treatment of CD.
Research methods
The baseline characteristics, operative data, and short-term (30-d) and long-term outcomes of patients with CD who underwent LIR and OIR between January 2017 and January 2020 were retrieved from an electronic database and retrospectively reviewed.
Research results
A total of 60 eligible patients were enrolled into the study, including 48 in the LIR group and 12 in the OIR group. There were no statistically significant differences in baseline characteristics, operative data, or short-term and long-term outcomes between the two groups. However, patients in the LIR group more frequently required lysis of adhesions as compared to those in the OIR group. Notably, following exclusion of patients who underwent enterectomy plus IR, OIR was more advantageous in terms of postoperative recovery of gastrointestinal function and hospitalization costs.
Research conclusions
The safety and feasibility of LIR for the treatment of CD are comparable to those of OIR with no increase in intraoperative or postoperative complications.
Research perspectives
LIR is feasible and safe for the treatment of CD patients with IR, and the short-term and long-term results are similar to those of OIR, thus further studies are warranted. In view of the fact that this is a retrospective study with a small sample size, larger prospective trials are required to further confirm these findings.
