LAPAROSCOPIC SURGERY IN CROHNS-DISEASE

In a prospective study the feasibility and safety of laparoscopic-assi sted ileocaecal resection for Crohn's disease was studied and compared with 16 patients who had open ileocaecal resection, and the value of laparoscopic stoma surgery was assessed. From January to November 1995 laparoscopic-assisted ileocaecal resection for Crohn's disease was un dertaken in 7 patients, laparoscopic-assisted stoma formation in 10 pa tients. In 1 patient laparoscopic ileocaecal resection was converted t o open surgery due to an unrecognised ileocolic fistula. Operating tim e in laparoscopic-assisted ileocaecal resections was longer than in op en ileocaecal resection (150 vs. 127 min, P = 0.7). Blood loss (386 vs . 445 mi, P = 0.7), first bowel movement (3.5 vs. 4.9 postoperative da ys, P = 0.07) and postoperative time to discharge (5.2 vs. 9.9 days, P < 0.01) in patients who had a laparoscopic-assisted ileocaecal resect ion were less than in patients who had open surgery, In all 10 patient s laparoscopic formation of a stoma was possible. Operating time was 6 2 min. Oral solids were restored on the 1.5 postoperative day. Mean po stoperative stay was 8.8 days, prolonged due to time needed for stoma- care training. These preliminary results indicate that laparoscopic-as sisted ileocaecal resection and stoma surgery for Crohn's disease are feasible and safe. Both procedures are characterised by rapid recovery and superior cosmetic results.