The feasibility and short-term clinical outcomes of single-incision laparoscopic surgery for patients with complex Crohn's disease.

Maeda, Kiyoshi; Nagahara, Hisashi; Shibutani, Masatsune; Fukuoka, Tatsunari; Nakao, Shigetomi; Yamagami, Hirokazu; Kamata, Noriko; Muguruma, Kazuya; Tanaka, Hiroaki; Toyokawa, Takahiro; Hirakawa, Kosei; Ohira, Masaichi

PURPOSE Single-incision laparoscopic surgery (SILS) offers excellent cosmetic results compared with conventional multi-port laparoscopic surgery. Recently, this technique has been applied to Crohn's disease (CD) with primary ileocolic strictures; however, the application of a laparoscopic approach for complex CD, which involves abscess formation, fistula formation, and recurrent CD, is controversial. The aim of this study was to investigate the safety and feasibility of SILS for patients with complex disease and to compare its clinical results in patients with complex disease vs. those with simple stricture disease. METHODS Fifty patients who underwent SILS for CD were divided into two groups: those with complex disease (complex group, n = 25), and those with simple strictures (simple group, n = 25). The preoperative data and clinical outcomes were analyzed and compared between the groups. RESULTS The operative time, blood loss and length of laparotomy incision were not significantly different between the groups. Although the rate of conversion and need for an additional port tended to be higher in the complex group, the rate of postoperative complications and length of hospital stay did not differ significantly between the groups. CONCLUSION SILS may be feasible for carefully selected patients with complex CD.