Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique
Background: Despite many advances in the medical management of Crohn's disease (CD), there is still a significant risk of surgical resection for lack of response to medical management or complications during the lifetime of a patient. Laparoscopic surgery offers short-term benefits such as decr...
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Format: | Article |
Language: | English |
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Wolters Kluwer Medknow Publications
2020-01-01
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Series: | Journal of Minimal Access Surgery |
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Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2020;volume=16;issue=1;spage=90;epage=93;aulast=Celentano |
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author | Valerio Celentano |
author_facet | Valerio Celentano |
author_sort | Valerio Celentano |
collection | DOAJ |
description | Background: Despite many advances in the medical management of Crohn's disease (CD), there is still a significant risk of surgical resection for lack of response to medical management or complications during the lifetime of a patient. Laparoscopic surgery offers short-term benefits such as decreased pain, lower wound complication rates, earlier resumption of diet and bowel function, better cosmesis and shorter hospital stays, while reduced post-operative adhesions and lower incisional hernia rate may represent long-term benefits.
Methods: A modular, standardised laparoscopic approach can be applied to safely perform laparoscopic redo surgery in the hostile setting of the recurrent CD and to facilitate teaching and training of these advanced procedures.
Results: Laparoscopic surgery in CD can be particularly challenging due to multifocal disease with extensive inflammation and a thickened mesentery, the potential for abscesses, fistulas and phlegmons and high conversion rates have been reported in reoperative surgery for recurrent CD with abscesses and adhesions representing the main reasons for conversion.
Conclusions: A standardised laparoscopic approach for redo surgery in recurrent CD has been described. Multidisciplinary management of CD is essential and bowel preservation must be the priority. |
first_indexed | 2024-12-22T05:47:42Z |
format | Article |
id | doaj.art-68716701f3784fc1841a04ed99d4a2fb |
institution | Directory Open Access Journal |
issn | 0972-9941 1998-3921 |
language | English |
last_indexed | 2024-12-22T05:47:42Z |
publishDate | 2020-01-01 |
publisher | Wolters Kluwer Medknow Publications |
record_format | Article |
series | Journal of Minimal Access Surgery |
spelling | doaj.art-68716701f3784fc1841a04ed99d4a2fb2022-12-21T18:36:58ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212020-01-01161909310.4103/jmas.JMAS_144_18Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised techniqueValerio CelentanoBackground: Despite many advances in the medical management of Crohn's disease (CD), there is still a significant risk of surgical resection for lack of response to medical management or complications during the lifetime of a patient. Laparoscopic surgery offers short-term benefits such as decreased pain, lower wound complication rates, earlier resumption of diet and bowel function, better cosmesis and shorter hospital stays, while reduced post-operative adhesions and lower incisional hernia rate may represent long-term benefits. Methods: A modular, standardised laparoscopic approach can be applied to safely perform laparoscopic redo surgery in the hostile setting of the recurrent CD and to facilitate teaching and training of these advanced procedures. Results: Laparoscopic surgery in CD can be particularly challenging due to multifocal disease with extensive inflammation and a thickened mesentery, the potential for abscesses, fistulas and phlegmons and high conversion rates have been reported in reoperative surgery for recurrent CD with abscesses and adhesions representing the main reasons for conversion. Conclusions: A standardised laparoscopic approach for redo surgery in recurrent CD has been described. Multidisciplinary management of CD is essential and bowel preservation must be the priority.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2020;volume=16;issue=1;spage=90;epage=93;aulast=Celentanoanastomotic recurrencecrohn's diseaseileocolic resectionlaparoscopic surgeryredo surgery |
spellingShingle | Valerio Celentano Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique Journal of Minimal Access Surgery anastomotic recurrence crohn's disease ileocolic resection laparoscopic surgery redo surgery |
title | Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique |
title_full | Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique |
title_fullStr | Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique |
title_full_unstemmed | Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique |
title_short | Laparoscopic redo surgery in recurrent ileocolic Crohn's disease: A standardised technique |
title_sort | laparoscopic redo surgery in recurrent ileocolic crohn s disease a standardised technique |
topic | anastomotic recurrence crohn's disease ileocolic resection laparoscopic surgery redo surgery |
url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2020;volume=16;issue=1;spage=90;epage=93;aulast=Celentano |
work_keys_str_mv | AT valeriocelentano laparoscopicredosurgeryinrecurrentileocoliccrohnsdiseaseastandardisedtechnique |