Laparoscopic surgery for inflammatory bowel disease

Background: Common laparoscopic colorectal procedures in patients with Croh n's disease include ileocolic resection and subtotal colectomy. The aim of this study was to compare and contrast the results of these two procedures. Methods. Patients who underwent one of these procedures between June 1992 a nd January 1999 were identified and included in the: study. Statistical ana lysis was performed using the Mann-Whitney test, Student's t-test, or Fishe r's exact test. Results: In all 109 patients (63 women and 46 men) with an average age of 3 6.7 years (range, 15-74) underwent ileocolic resection (ICR), while 21 pati ents (16 women and five men) with an average age of 36.5 years (range, 18-7 7) underwent subtotal colectomy (STC) (p = NS). There were 14 intraoperativ e complications, eight (7%) in the ICR group and six (29%) in the STC group (p = 0.01). Total operative time was 167 min (range, 90-285) in the ICR gr oup and 231 min (range, 140-340) in the STC group (p < 0.01). Despite this difference in operating time, the hospital stays were very similar at 8.8 d ays (range, 3-27) and 8.8 days (range, 3-14) (p = NS). In 19 (17%) of the I CR patients and five (24%) of the STC patients, their procedure was convert ed to a laparotomy (p = MS). In the ICR group, 20 of the patients (18%) had surgery-related postoperative complications, including five anastomotic le aks. In the STC group, six of the patients (29%) had surgery-related compli cations, including two anastomotic leaks (p = NS). Conclusion: Although STC is a far more extensive procedure than ICR, the ov erall postoperative complication rate is not significantly different betwee n the two groups; however, we found that there were more intraoperative com plications associated with STC.