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Evidence summaries

Laparoscopic Versus Open Surgery for Small Bowel Crohn's Disease

Laparoscopic surgery may be as safe as open operation for small bowel Crohn's disease. Level of evidence: "C"

The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by potential reporting bias (only few small trials reported).

Summary

A Cochrane review [Abstract] 1 included included two RCTs with a total of 120 patients to determine if there is a difference in the perioperative outcomes and re-operation rates for disease recurrence following laparoscopic surgery compared to open surgery in small bowel Crohn's disease.

There was no statistically significant difference between any of the compared outcomes between laparoscopic and open surgery. Laparoscopic surgery appeared to be associated with reduced number of wound infections (1/61 versus 9/59) and reduced re-operation rates for non disease related complications (3/57 versus 7/54) but the differences were not statistically significant (p=0.23 and 0.19 respectively).

Clinical comments

Complication rates in laparoscopic procedures may differ between skilled and less experienced surgeons.

Note

Date of latest search:

References

  • Dasari BV, McKay D, Gardiner K. Laparoscopic versus Open surgery for small bowel Crohn's disease. Cochrane Database Syst Rev 2011;(1):CD006956. [PubMed]

Primary/Secondary Keywords