Introduction: Single-incision laparoscopic surgery (SILS) aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single site, potentially offering better cosmetic results and decreased postoperative pain. In this study, we compare the results of SILS ileocolic resection for Crohn’s disease (CD) to conventional laparoscopy and open surgery using a propensity score–matched analysis in a retrospective national multicentre study. Methods: All consecutive patients undergoing elective SILS ileocaecal or redo ileocolic resection for primary and recurrent CD from 1 June 2018 to 31 May 2019 were included. Patients were matched 1:1:1 with laparoscopy and open surgery according to perianal disease, recurrent disease, penetrating phenotype of CD, history of previous abdominal surgery, preoperative medical treatment with steroids and anti-TNF. Postoperative morbidity within 30 days of surgery was the primary endpoint. Results: Fifty-eight patients were included in each group, for a total of 174 patients. The conversion rate for SILS and laparoscopy was 10.3% and 12%, respectively, with no difference in the incidence of postoperative complications (13.8% and 12%, p = 0.77), whilst open surgery demonstrated a worse morbidity profile, with a complication rate of 25.9% (p < 0.0001). Median length of hospital stay following SILS ileocolic resection was 5 days, significantly shorter compared to 7 days for laparoscopy and 9 for open surgery (p < 0.0001). Conclusions: SILS ileocolonic resection for CD demonstrated a comparable morbidity profile compared to laparoscopy in selected patients, with a reduced length of postoperative hospital stay. (Collaboration Group: SICCR Current Status Crohns Dis Su)

Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis / V. Celentano, G. Pellino, M. Rottoli, F. Colombo, G. Sampietro, A. Spinelli, F. Selvaggi, V. Celentano, G. Poggioli, G. Sica, M.C. Giglio, M. Campanelli, C. Coco, G. Rizzo, F. Sionne, G. Lamperti, D. Foschi, F. Ficari, L. Vacca, M. Cricchio, F. Giudici, L. Selvaggi, G. Sciaudone, R. Peltrini, A. Manfreda, L. Bucci, R. Galleano, O. Ghazouani, L. Zorcolo, S. Deidda, A. Restivo, A. Braini, F. Di Candido, M. Sacchi, M. Carvello, S. Martorana, G. Bordignon, I. Angriman, A. Variola, M. Di Ruscio, G. Barugola, A. Geccherle, F.P. Tropeano, G. Luglio, M. Tanzanu, D. Sasia, M. Migliore, M.C. Giuffrida, E. Marrano, G. Moretto, H. Impellizzeri, G. Gallo, G. Vescio, G. Sammarco, G. Terrosu, G. Calini, A. Bondurri, A. Maffioli, G. Zaffaroni, A. Resegotti, M. Mistrangelo, M.E. Allaix, F. Botti, M. Prati, L. Boni, S. Perotti, M. Mineccia, A. Giuliani, L. Romano, G.M.P. Graziano, L. Pugliese, A. Pietrabissa, G.G. Delaini. - In: INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. - ISSN 0179-1958. - 36:3(2021 Mar), pp. 605-608. [10.1007/s00384-020-03821-6]

Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis

M. Rottoli;F. Colombo;C. Coco;D. Foschi;G. Terrosu
Membro del Collaboration Group
;
A. Bondurri
Membro del Collaboration Group
;
A. Maffioli
Membro del Collaboration Group
;
G. Zaffaroni
Membro del Collaboration Group
;
F. Botti
Membro del Collaboration Group
;
M. Prati
Membro del Collaboration Group
;
L. Boni
Membro del Collaboration Group
;
L. Pugliese
Membro del Collaboration Group
;
2021-03

Abstract

Introduction: Single-incision laparoscopic surgery (SILS) aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single site, potentially offering better cosmetic results and decreased postoperative pain. In this study, we compare the results of SILS ileocolic resection for Crohn’s disease (CD) to conventional laparoscopy and open surgery using a propensity score–matched analysis in a retrospective national multicentre study. Methods: All consecutive patients undergoing elective SILS ileocaecal or redo ileocolic resection for primary and recurrent CD from 1 June 2018 to 31 May 2019 were included. Patients were matched 1:1:1 with laparoscopy and open surgery according to perianal disease, recurrent disease, penetrating phenotype of CD, history of previous abdominal surgery, preoperative medical treatment with steroids and anti-TNF. Postoperative morbidity within 30 days of surgery was the primary endpoint. Results: Fifty-eight patients were included in each group, for a total of 174 patients. The conversion rate for SILS and laparoscopy was 10.3% and 12%, respectively, with no difference in the incidence of postoperative complications (13.8% and 12%, p = 0.77), whilst open surgery demonstrated a worse morbidity profile, with a complication rate of 25.9% (p < 0.0001). Median length of hospital stay following SILS ileocolic resection was 5 days, significantly shorter compared to 7 days for laparoscopy and 9 for open surgery (p < 0.0001). Conclusions: SILS ileocolonic resection for CD demonstrated a comparable morbidity profile compared to laparoscopy in selected patients, with a reduced length of postoperative hospital stay. (Collaboration Group: SICCR Current Status Crohns Dis Su)
Crohn’s disease; Inflammatory Bowel Disease; Single-incision laparoscopic surgery; Humans; Length of Stay; Postoperative Complications; Propensity Score; Retrospective Studies; Treatment Outcome; Tumor Necrosis Factor Inhibitors; Crohn Disease; Laparoscopy
Settore MED/18 - Chirurgia Generale
23-dic-2020
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/896424
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