Safety and feasibility of single-incision laparoscopic surgery in the treatment of Crohn′s disease

Abstract

Objective Single-incision laparoscopic surgery (SILS) with enhanced recovery after surgery can reduce operation trauma and accelerate postoperative rehabilitation.This study aims to investigate the safety and feasibility of SILS with ERAS in the treatment of Crohn′s disease. Methods Total 32 patients with Crohn′s disease were randomly assigned to receive traditional laparoscopic surgery (n=15) and SILS (n=17), who underwent laparoscopic partial small intestine resection in our department were collected. Database was established and analyzed retrospectively. Additionally, intraoperative bleeding, operation time, postoperative anal first exhaust time, hospitalization expenses, postoperative inflammation index were compared between single and multiple port laparoscopic hepatectomy respectively. Results 17 patients were performed with single port laparoscopic partial small intestine resection successfully, no case of conversion to laparotomy or adding incision. There was no clinically significant difference between two groups in terms of intraoperative bleeding, postoperative complication rate, postoperative anal first exhaust time (P>0.05). However, the operation time of single port laparoscopic was longer than the conventional laparoscopic surgery [(113.3±27.2)min vs (89.2±22.8)min, P<0.01]. There were significant differences in the postoperative hospital stay and hospitalization expenses between the two groups (P<0.05). WBC, CRP and PCT in SILS group was lower than those in the control group at the first days and the third days after operation, the differences were statistically significant (P<0.05). There was no case of postoperative abdominal infection, abscess and intestinal fistula or other complications. Conclusion SILS can shorten postoperative hospital stay and facilitate bowel function recovery in the treatment of Crohn′s disease. It is worthwhile to mention the nice cosmetic benefits of SILS, the perioperative SILS is safe and feasible and should be popularized in Crohn′s disease. Key words: Single-incision laparoscopic surgery; Laparoscopic surgery; Crohn′s disease