LAPAROSCOPY FOR INFLAMMATORY BOWEL-DISEASE - PROS AND CONS

The role of laparoscopic surgery in the treatment of colorectal malign ancies is still under investigation, although it can offer significant benefits to man., patients viith inflammatory bowel disease (IBD). Th e aim of this study was to assess the pros and cons of the laparoscopi c management of IBD. Data were obtained from a review of the literatur e published since 1992, when the first report of laparoscopic surgery for IBD appeared in print, From 1992 to 1997 several series of laparos copic colorectal surgery for the management of IBD have been reported. ii close evaluation of these studies revealed that laparoscopy in pat ients with terminal ileal Crohn's disease or anal Crohn's disease in n eed of fecal diversion offers significant advantages compared to lapar otomy, including decreased pain, length of hospitalization, and disabi lity. An additional bonus is improved cosmesis and a reduction in symp tomatic postoperative adhesions. These many benefits can be achieved w ithout any increase in morbidity or expense, Conversely, the use of th is technology for restorative proctocolectomy in patients with mucosal ulcerative colitis is associated with a longer operative time and an increased incidence of both intra-and postoperative complications comp ared to laparotomy. Laparoscopic colorectal surgery can thus be advant ageous for treatment of terminal ileal Crohn's disease but cannot he r outinely justified for the treatment of mucosal ulcerative colitis.