Laparoscopic Ileo-Cecectomy for Crohn's Disease with Side to Side Stapled Anastomosis: 21 Consecutive Cases

Gianfranco Cocorullo, Valentina Giaccaglia, Roberta Tutino, Maria Cappello, Nicola Falco, Tommaso Fontana, Giuseppe Salamone and Gaspare Gulotta

Department of General and Emergency Surgery, ‘Paolo Giaccone’ University Hospital, Italy
Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Italy
Department of Gastroenterology, ‘Paolo Giaccone’ University Hospital, Italy

^*Correspondance to: Valentina Giaccaglia 

 PDF  Full Text DOI: 10.25107/2474-1647.1331

Abstract

Introduction: Terminal ileum is the most involved tract in Crohn’s disease and its obstruction is one of the most frequent complications. Surgery plays an important role both in the management of chronic strictures and in acute complications not improving with medical therapy.Methods: We investigated the outcomes of laparoscopic ileo-cecectomy with mechanical anastomosis in patients affected by Crohn’s, evaluating intra-operative safety and postoperative outcomes such as bleeding and anastomotic leak.Results: From January 2011 to December 2015, 21 patients underwent laparoscopic ileo-cecectomy with stapled extracorporeal ileo-colic side-to-side anti-peristaltic anastomosis for complicated Crohn’s disease. Twelve patients (57.1%) were admitted in emergency setting. Mean operating room time was 154 minutes; in 4 patients conversion to open technique was necessary. Total morbidity rate was 19%, with 2 reoperations (9.5%), one due to staple-line bleeding and the other to anastomotic leak (4.7%). Mean hospital stays in uncomplicated and complicated patients were respectively 5.8 and 14 days.Conclusion: In the management of complicated Crohn’s disease, laparoscopic ileo-cecectomy with stapled extracorporeal anastomosis seems to be a safe technique, in spite of the well known fistulizing nature of the disease, and also easy to perform.

Keywords

Crohn’s disease; Ileo-cecectomy; Laparoscopy

Cite the article

Cocorullo G, Giaccaglia V, Tutino R, Cappello M, Falco N, Fontana T, et al. Laparoscopic Ileo-Cecectomy for Crohn's Disease with Side to Side Stapled Anastomosis: 21 Consecutive Cases. Clin Surg. 2017; 2: 1331.