Ileocolic Resection for Complex Crohn's Disease

Study Overview
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Brief Summary
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Laparoscopic ileocolic resection is the preferred surgical approach for patients with ileocecal Crohn's disease (CD). Objective of this study was to evaluate the efficacy of a minimally invasive gas-less ileocolic resection in complex cases of CD through a Mc Burney incision, in patients who already had a previous appendectomy.

Detailed Description
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From January 2016 to December 2017, all consecutive CD patients with primary or recurrent complex disease referred for IC resection were evaluated for the study purpose.Complex disease patients presenting McBurney incision for a previous open appendectomy were included in the group of study. This group was compared with a control group of CD patients with the same clinical characteristics of ileocolic disease who underwent standard laparoscopic IC resection, pooled out from the database of IC resections for CD of the Minimally Invasive and Gastrointestinal Surgery Unit of Tor Vergata Hospital, Rome, Italy. Data on demographics, BMI, type and behavior of CD, presence of disease apart from ileocecal site, previous surgery, recurrence, current medical treatment, thickening of the mesentery, preoperative imaging results (MR enterography or small intestine contrast ultrasound), operative time, blood loss, conversion to laparoscopy and conversion to open rates, complications, adherence rate to ERAS protocols and length of hospital stay were collected for the study purpose.

Official Title
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Minimally Invasive Open Technique for Ileo-colic Resection in Complex Cases of Terminal Ileum Crohn's Disease. Case Series.

Conditions
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Crohn Disease of Ileum

Intervention / Treatment
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* Procedure: ileocolic resection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosed Crohn's disease previous appendectomy trough a mcburney incision Exclusion Criteria: patients with major comorbidities age>75 previous midline laparotomy
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study Group<br>patients with complex crohn's disease who had a previous open appendectomy through a mc burney incision scheduled for ileo-colic resection through the same incision | Procedure: ileocolic resection<br>* Ileocolic resection through McBurney incision<br>|
| Control Group<br>patients with complex crohn's disease who had a previous open appendectomy through a mc burney incision scheduled for ileo-colic resection who underwent standard laparoscopic resection | Procedure: ileocolic resection<br>* Ileocolic resection through McBurney incision<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean operative time | duration of surgical procedure | 75-156 minutes | 
| Mean blood loss during surgical procedure | blood loss from the beginning to the end of the procedure | 2 hours | 
| Mean post-operative hospital stay | time from day of surgery to discharge | 3-7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post-operative complications | complications according to Clavien Dindo classification | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Crohn Disease, Ileocolic resection, Appendectomy, Single-port incision, McBurney, Laparoscopy