Preliminary study of short- and long-term outcome and quality of life after minimally invasive surgery for Crohn's disease: Comparison between single incision, robotic-assisted and conventional laparoscopy.
Crohn's disease
minimally invasive surgery
quality of life
Journal
Journal of minimal access surgery
ISSN: 0972-9941
Titre abrégé: J Minim Access Surg
Pays: India
ID NLM: 101228183
Informations de publication
Date de publication:
Historique:
pubmed:
30
4
2019
medline:
30
4
2019
entrez:
30
4
2019
Statut:
ppublish
Résumé
The feasibility of minimally invasive approach for Crohn's disease (CD) is still controversial. However, several meta-analysis and retrospective studies demonstrated the safety and benefits of laparoscopy for CD patients. Laparoscopic surgery can also be considered for complex disease and recurrent disease. The aim of this study was to investigate retrospectively the effect of three minimally invasive techniques on short- and long-term post-operative outcome. We analysed CD patients underwent minimally invasive surgery in the Digestive Surgery Unit at Careggi University Hospital (from January 2012 to March 2017). Short-term outcome was evaluated with Clavien-Dindo classification and visual analogue scale for post-operative pain. Long-term outcome was evaluated through four questionnaires: Short Form Health Survey (SF-36), Gastrointestinal Quality Of Life Index (GIQLI), Body Image Questionnaire (BIQ) and Hospital Experience Questionnaire (HEQ). There were 89 patients: 63 conventional laparoscopy, 16 single-incision laparoscopic surgery and 10 robotic-assisted laparoscopy (RALS). Serum albumin <30 g/L (P = 0.031) resulted to be a risk factor for post-operative complications. HEQ had a better result for RALS (P = 0.019), while no differences resulted for SF-36, BIQ and GIQLI. Minimally invasive technique for CD is feasible, even for complicated and recurrent disease. Our study demonstrated low rates of post-operative complications. However, it is a preliminary study with a small sample size. Further studies should be performed to assess the best surgical technique.
Sections du résumé
BACKGROUND
BACKGROUND
The feasibility of minimally invasive approach for Crohn's disease (CD) is still controversial. However, several meta-analysis and retrospective studies demonstrated the safety and benefits of laparoscopy for CD patients. Laparoscopic surgery can also be considered for complex disease and recurrent disease. The aim of this study was to investigate retrospectively the effect of three minimally invasive techniques on short- and long-term post-operative outcome.
PATIENTS AND METHODS
METHODS
We analysed CD patients underwent minimally invasive surgery in the Digestive Surgery Unit at Careggi University Hospital (from January 2012 to March 2017). Short-term outcome was evaluated with Clavien-Dindo classification and visual analogue scale for post-operative pain. Long-term outcome was evaluated through four questionnaires: Short Form Health Survey (SF-36), Gastrointestinal Quality Of Life Index (GIQLI), Body Image Questionnaire (BIQ) and Hospital Experience Questionnaire (HEQ).
RESULTS
RESULTS
There were 89 patients: 63 conventional laparoscopy, 16 single-incision laparoscopic surgery and 10 robotic-assisted laparoscopy (RALS). Serum albumin <30 g/L (P = 0.031) resulted to be a risk factor for post-operative complications. HEQ had a better result for RALS (P = 0.019), while no differences resulted for SF-36, BIQ and GIQLI.
CONCLUSIONS
CONCLUSIONS
Minimally invasive technique for CD is feasible, even for complicated and recurrent disease. Our study demonstrated low rates of post-operative complications. However, it is a preliminary study with a small sample size. Further studies should be performed to assess the best surgical technique.
Identifiants
pubmed: 31031322
pii: 256957
doi: 10.4103/jmas.JMAS_61_19
pmc: PMC7597873
doi:
Types de publication
Journal Article
Langues
eng
Pagination
364-371Déclaration de conflit d'intérêts
None
Références
Surg Endosc. 2006 Jul;20(7):1036-44
pubmed: 16715212
Int J Colorectal Dis. 2008 Oct;23(10):1013-6
pubmed: 18607608
Surg Endosc. 2005 Dec;19(12):1549-55
pubmed: 16235128
Inflamm Bowel Dis. 2010 Aug;16(8):1273-4
pubmed: 19902539
Cancer. 2001 Feb 15;91(4):854-62
pubmed: 11241255
Am J Surg. 2004 Jan;187(1):47-51
pubmed: 14706585
J Visc Surg. 2013 Dec;150(6):389-93
pubmed: 24119432
Surg Endosc. 2009 Oct;23(10):2380-4
pubmed: 19263141
World J Gastroenterol. 2008 Sep 28;14(36):5532-9
pubmed: 18810772
Gut. 1988 Jan;29(1):49-56
pubmed: 3343012
Colorectal Dis. 2011 Mar;13(3):302-7
pubmed: 19912288
J Crohns Colitis. 2014 Sep;8(9):1055-61
pubmed: 24589026
Gut. 2010 Sep;59(9):1200-6
pubmed: 20650924
J Gastrointest Surg. 2015 Jun;19(6):1007-14
pubmed: 25820486
Br J Surg. 2000 Dec;87(12):1697-701
pubmed: 11122187
Cochrane Database Syst Rev. 2011 Jan 19;(1):CD006956
pubmed: 21249684
Dig Dis Sci. 2019 Jul;64(7):1959-1966
pubmed: 30684075
BMC Surg. 2013 May 24;13:14
pubmed: 23705825
J Clin Imaging Sci. 2011;1:37
pubmed: 21966634
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Tunis Med. 2015 Jun;93(6):356-60
pubmed: 26644097
Gastroenterology. 1994 Dec;107(6):1675-9
pubmed: 7958678
Colorectal Dis. 2012 May;14(5):572-7
pubmed: 21831174
Dis Colon Rectum. 2006 Jan;49(1):58-63
pubmed: 16328612
Colorectal Dis. 2007 Nov;9(9):825-9
pubmed: 17645573
Surg Endosc. 2009 Aug;23(8):1876-81
pubmed: 19184211
Gut. 1985 Feb;26(2):146-50
pubmed: 3967832
World J Gastroenterol. 2016 Oct 28;22(40):8892-8904
pubmed: 27833380
Best Pract Res Clin Gastroenterol. 2014 Feb;28(1):183-94
pubmed: 24485265