Recent results of laparoscopic surgery in inflammatory bowel disease

Table 1 Overview of most important study results dealing with laparoscopic and open surgical management of inflammatory bowel diseases

Author	Yr	Patients	Findings
Crohn’s disease
Umanskiy et al[8]	2010	55 lap colect	Early postop. results favourable for laparoscopy
		70 open colect
El-Gazzaz et al[12]	2010	643 matched cases open and laparosc	Anastomotic leak rates even for open and lap surgery
Nguyen et al[13]	2009	335 laparoscopic	Postop compl. rate 13% (leaks, obstruction, bleeding)
Eshuis et al[14]	2010	29 laparoscopic	Better cosmesis for laparoscopy, more hernias and obstructions in open surgery
		26 open
Stocchi et al[15]	2008	Follow-up, randomized study	Open colectomy patients significantly more frequently requiring multiple reoperations, otherwise results similar
		27 lap, 29 open
Goyer et al[16]	2009	54, complex CD	In complex disease, significantly longer OR time, conversion rate and stoma frequency
		70, uncomplicated
Holubar et al[17]	2010	30 lap completed	Significantly more adhesions and length of stay in conversion, complication rates even
		10 converted
Nakajima et al[21]	2010	14 open	Significantly longer OR time in laparoscopic cases, significantly less blood loss in lap. and hand-assisted cases
		6 lap
		18 hand-assisted
Canedo et al[23]	2010	127 BMI < 25 kg/m2	More conversions in obesity, no differences in postop. complications and hospital stays
		67 BMI > 25 kg/m2, < 30 kg/m2
		19 BMI > 30 kg/m2
Lesperance et al[24]	2009	Nationwide study	Less complications, shorter hospital stays, lower charges and mortality in laparosopy, applied mainly in younger female patients with ileocecal disease at lower stage
		49.609 surg. cases
		2.826 lap cases
Tan et al[25]	2007	Metaanalysis	Conversion rate 11.2%, lap. surgery with significantly longer OR time, more rapid recovery, shorter hospital stay and lower morbidity, similar recurrence rates
		14 studies
		881 patients
Ulcerative colitis
Holubar et al[43]	2009	Total proctocolect	Median OR time 329 min, hospital stay 5 d, major complications in 9%, no mortality
		23 hand-assisted
		13 lap-assisted
		8 lap-“incisionless”
Berdah et al[45]	2009	68 RPC + pouch	30% complication rate, all patients resuming preop. grade of activity, 90% satisfaction “good/very good”
Fichera et al[46]	2009	RPC + pouch	In laparoscopy, faster resumption of bowel function, less blood loss and lower rate of hernias in follow-up
		73 lap, 106 open
Larson et al[47]	2008	RPC + pouch	Long-term data, worse sexual functional results in lap. cases, better body image and quality of life
		100 lap, 189 open
Indar et al[48]	2008	34, RPC + pouch	Adhesion evaluation at ileostomy closure : 68% no and 32% few adhesions, lower than in open surgery
Tsuruta et al[49]	2009	30, HALS-RPC	OR time significantly longer for lap-RPC, incision length significantly longer for HALS-RPC
		40, Lap-RPC
Watanabe et al[50]	2009	Emergency colect	For HALS, OR time significantly longer, postop. complication rate significantly lower
		30 HALS, 30 open
Holubar et al[51]	2009	Fulminant colitis, 36 lap-assist. colect	Conversion rate 6%, median lengths of stay 4 d in both 14 HALS colect. groups, subsequent completion proctectomy in 42 pat
Chung et al[52]	2009	Severe UC	Faster recovery and progression to completion of RPC in lap. colectomies patients
		37 lap., 41 open
Wu et al[56,57]	2008	Metaanalysis	Overall complication rate higher in open surgery duration of lap surgery significantly extended
	2010	16 controlled trials
Ahmed Ali et al[58]	2009	Cochrane review	OR time significantly longer in lap. surgery, no differences in postop. course or recovery between lap. and open procedures
		11 studies, 607 pat
		253 laparoscopic

CD: Crohn’s disease; UC: Ulcerative colitis; OR: Operation room; BMI: Body mass index; HALS: Hand-assisted laparoscopic surgery; RPC: Restorative proctocolectomy.