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...

Full description

Bibliographic Details
Main Author: Valerio Celentano
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Journal of Minimal Access Surgery
Subjects:
Online Access:http://www.journalofmas.com/article.asp?issn=0972-9941;year=2020;volume=16;issue=1;spage=90;epage=93;aulast=Celentano
_version_ 1819118364545515520
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