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Single-Port Ileocaecal Resection for Crohn's Disease: a Multicenter Case-Matched Comparison With Multi-Port Laparoscopy
Antonino Spinelli*1, 4, Andre D'Hoore2, Elisabeth J. De Groof3, Matteo Sacchi1, Anthony De Buck Van Overstraten2, Marco Montorsi1, Willem a. Bemelman3
1Department of General and Digestive Surgery, Humanitas Research Hospital, Rozzano Milano, Italy; 2Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium; 3Department of Surgery, Academic Medical Centre, Amsterdam, Netherlands; 4University of Milano, Milano, Italy
Objectives: Aim of this study is to compare short term surgical outcomes between single-port (SP) and multi-port (MP) laparoscopic ileocaecal resection (LICR) for Crohn's disease (CD) in a large series of patients operated in three European tertiary referral centers.
Background data: The feasibility of SP LICR in CD has previously been reported. However, only few studies, including small numbers of patients compared a SP with a MP laparoscopic approach.
Methods: 101 consecutive patients underwent SP LICR between March 2010 and October 2014. A case-matched comparison was performed with a historical cohort of 156 patients who underwent MP LICR (February 1999 to December 2013). Endpoints were short-term outcomes and postoperative need for opioid drug to obtain adequate pain control.
Results: The two groups were matched for age, sex, body mass index (BMI) and indication for surgery. No significant differences were observed in duration of surgery, conversion rate, intraoperative complications and stoma formation rate. Postoperatively no significant differences were observed in complications, ileus, solid diet intake, length of stay and readmission rate. Visual analogue scale (VAS), used as a measure of adequate pain control, was maintained < 3. Significant less opioids in the SP group were needed in comparison to the MP group (p=0.007) to obtain this pain control.
Conclusions: Short term outcomes did not differ in SP versus MP LICR for CD except for a significantly lower requirement of opioid drugs.
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