Back to Journals » Open Access Surgery » Volume 10

Long-term outcome of laparoscopic and open surgery in patients with Crohn’s disease

Authors Hoffmann M, Siebrasse D, Schlöricke E, Bouchard R, Keck T, Benecke C

Received 18 May 2017

Accepted for publication 28 July 2017

Published 7 November 2017 Volume 2017:10 Pages 45—54


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Luigi Bonavina

Martin Hoffmann,1 Dina Siebrasse,1 Erik Schlöricke,2 Ralf Bouchard,1 Tobias Keck,1 Claudia Benecke1

1Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, 2Department of Surgery, Westküstenklinikum Heide, Heide, Germany

Aim: To investigate, via data analysis, the long-term outcome of patients who underwent either laparoscopic or open surgery for Crohn’s disease.
Methods: A total of 113 patients who had undergone first abdominal surgery due to Crohn’s disease between January 2000 and December 2010 in a maximum care provider facility, were included in the statistical analysis. All patients provided their informed consent prior to inclusion. Data were collected from a database. Follow-up data included data from central mortality registries, general practitioners and a specialized clinic. Statistical analysis of the general patient data and the different operations and approaches were performed with the use of chi-square test, Fisher’s exact test, and the Mann–Whitney U test.
Results: The median follow-up period in case of open and laparoscopic surgery was found to be 9 and 6 years, respectively. Statistically significant differences were observed for the following parameters in case of open and laparoscopic surgery, respectively: age (median=44 vs. 36 years, range=15–76 vs. 15–72 years; p=0.007), urgency of operation (23 out of 34 planned vs. 6 out of 70 planned; p<0.001), year of resection (median=2003 vs. 2006, range=2000–2010 vs. 2000–2010; p=0.001). The length of stay in hospital was significantly shorter in the laparoscopic group than that of open surgery group (8 vs. 11 days, respectively; p<0.0001). We did not control for factors such as age and comorbidities in our statistical analysis. We also did not find any differences with regard to perioperative and 90-day mortality, surgical complications, length of specimen, stoma, surgical recurrence rate (10% in both groups) and number of re-admissions. Moreover, we did not find differences between patients with early operation after first symptoms and patients with long course of disease. A statistically significant difference was found for long-term mortality that was higher in the open surgery group than that of laparoscopic group (p=0.005) (the median for open surgery group was significantly higher than that of laparoscopic group).
Conclusion: The outcome of laparoscopic and open surgery is at least comparable. Shorter length of hospital stay and comparable surgical recurrence rates are advantages of laparoscopy.

Keywords: Crohn’s disease, follow-up, retrospective, laparoscopic, open, outcome

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]