Laparoscopic intracorporeal anastomosis vs open anastomosis for ileostomy reversal in Crohn's disease: A single center retrospective study

Table 1 Baseline clinical characteristics of patients

Characteristics	OIR	LIIR	P value
Age (years)	28 (25-33)	26.5 (18.75-32)	0.242
Sex			0.526
Male	6 (40)	15 (50)
BMI (kg/m2)	19.5 (17.4-21.3)	18.55 (17.85-19.375)	0.166
ASA			0.092
I-II	10 (66.67)	12 (40)
III-IV	5 (33.33)	18 (60)
Duration of ileostomy retention (months)	8 (6-9)	6.5 (6-10)	0.836
Medication			0.446
Immunosuppressant	2 (13.33)	1 (3.33)
Biologics	12 (80)	27 (90)
5-ASA	1 (6.7)	2 (6.67)
WBC (109/L)	6.150 ± 1.405	6.198 ± 1.522	0.92
NE (109/L)	4.221 ± 1.377	3.802 ± 1.589	0.389
LYM (109/L)	1.2 (1.01-1.38)	1.315 (1.18-1.538)	0.393
PLT (109/L)	271.27 ± 59.977	247.33 ± 62.643	0.227
Hb (g/L)	131.13 ± 6.312	135.10 ± 9.767	0.161
ALB (g/L)	44.267 ± 6.344	44.043 ± 4.178	0.888
CRP (mg/L)	1.22 (0.79-2.58)	0.885 (0.77-8.158)	0.895
ESR (mm)	15 (8-18)	10.5 (6-15.25)	0.091

Values are showed as mean ± SD, median (IQR), or n (%). OIR: Open ileostomy reversal; LIIR: Laparoscopic intracorporeal ileostomy reversal; BMI: Body mass index; ASA: American Society of Anesthesiologists; WBC: White blood cell count; NE: Neutrophil; LYM: Lymphocyte; PLT: Blood platelet; Hb: Hemoglobin; ALB: Albumin; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.

Table 2 Intraoperative and postoperative outcomes

Variables	OIR	LIIR	P value
Operation time, minutes	194.4 ± 23.194	191.4 ± 34.152	0.761
Intraoperative hemorrhage (mL)	100 (70-100)	70 (60-100)	0.091
anastomotic site			0.118
Ileum-ileum	4 (26.67)	16 (53.33)
Ileum-colon	11 (73.33)	14 (46.67)
Enterolysis range			0.14
Around ileostomy	5 (33.33)	17 (56.67)
Distal and proximal bowel	10 (66.67)	13 (43.33)
First postoperative flatus, days	2 (2-3)	2 (1-2.25)	0.128
Postoperative complication	4 (26.67)	5 (16.67)	0.454
Anastomotic hemorrhage	0 (0)	2 (6.67)	0.545
Anastomotic leakage	0 (0)	0 (0)	1
Wound infection	2 (13.33)	1 (3.3)	0.254
Postoperative ileus	2 (13.33)	2 (6.67)	0.591
Reoperation	0 (0)	2 (6.67)	0.545
Postoperative days in the hospital, days	13 (11-16)	11 (10-12.25)	0.045
Total hospitalization costs (RMB)	34111 (31240-37892)	36211 (33220.25-40116.75)	0.038

Values are showed as mean ± SD, median (IQR), or n (%). OIR: Open ileostomy reversal; LIIR: Laparoscopic intracorporeal ileostomy reversal.

Table 3 Clinical outcomes for enteral nutrition intolerance

Variables	OIR	LIIR	P value
Total symptoms of feeding intolerance	7 (53.85)	4 (14.29)	0.019
Abdominal distension/pain	5 (38.46)	3 (10.71)	0.084
Nausea/vomiting	2 (15.38)	0 (0)	0.095
Diarrhea	5 (38.46)	4 (14.29)	0.113
Enteral nutrition intolerance	3 (23.08)	3 (10.71)	0.361
Time to total enteral nutrition (days)	6 (6-8.5)	6 (5-6)	0.033

Median (IQR), or n (%). OIR: Open ileostomy reversal; LIIR: Laparoscopic intracorporeal ileostomy reversal.

Table 4 Logistic multifactorial regression analysis of postoperative symptoms of enteral nutrition intolerance

Variables	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Sex	1.750 (0.422-7.253)	0.44
Age	0.988 (0.908-1.073)	0.768
BMI	1.342 (0.875-2.059)	0.178
Duration of stoma retention	1.309 (0.980-1.748)	0.068
anastomotic site	5.143 (0.947-27.921)	0.058
Enterolysis range	4.606 (1.007-21.072)	0.049	1.673(0.250-11.217)	0.596
Operation time	1.054 (1.013-1.095)	0.009	1.059(1.005-1.115)	0.031
anastomotic technique	0.143 (0.031-0.653)	0.012	0.120(0.017-0.862)	0.035

OR: Odds ratio; 95%CI: 95% confidence interval; BMI: Body mass index.