Long-term outcomes of laparoscopic versus open ileocolic resection for Crohn's disease: follow-up of a prospective randomized trial.

Overview

BACKGROUND: The purpose of this study was to analyze long-term recurrence rates and complications in patients previously enrolled in a prospective randomized trial comparing laparoscopic (LC) and open ileocolectomy (OC) for ileocolic Crohn's disease (CD). METHODS: Follow-up data were available on 56 of 60 patients. Demographic data, recurrence rates, need for additional surgery related to primary procedure, and medication use were recorded. RESULTS: Mean follow-up for 56 patients (27 LC vs 29 OC) was 10.5 years and comparable between LC and OC (10.0 vs 11.0, respectively; P = .64). One patient died 8 years after OC of causes unrelated to CD. Eight patients for each group underwent initial reoperative (26% LC vs 28% OC; P = .89). One patient underwent incisional hernia repair after LC (4%) versus 4 patients (14%) after OC (P = .61). Two patients in the LC group underwent adhesiolysis versus none after OC (P = .23). Incidences of anorectal disease, anorectal surgery, endoscopic or radiologic recurrence, and medication use were also similar between LC and OC. OC patients requiring operation during follow-up were significantly more likely than LC to require multiple operations (P = .006). CONCLUSIONS: Long-term data from this prospective randomized trial confirm that LC is at least comparable to OC in the treatment of ileocolic CD.