Single-Incision Laparoscopic Ileocecectomy in Children with Crohn's Disease

Abstract

Abstract

Introduction:

We previously reported our experience with standard laparoscopic ileocecectomy, but we have recently used a single-incision laparoscopic approach.

Patients and Methods:

We conducted a retrospective review of a single surgeon's experience from 2009 to 2013.

Results:

Twenty-eight children 11–18 years of age (mean, 15.5 years) with a mean body mass index of 18.9±3 kg/m² underwent single-incision laparoscopic ileocecectomy for Crohn's disease. Mean operative time was 86.5±25.9 minutes (range, 56–166 minutes). There were no extra ports placed or conversions to open surgery. Five children (18%) were on parenteral nutrition at time of surgery, 14 (50%) were on steroids, and 9 (32%) were on tumor necrotic factor inhibitors. A stapled extracorporeal anastomosis was performed in all children. Complications included abscess (n=4), small bowel obstruction (n=3), superficial wound infection (n=3), and small bowel perforation (n=1). Some patients had more than one complication. Of those with complications, 5 (56%) were on steroids, 5 (56%) were on tumor necrotic factor inhibitors, and 1 patient was on both. The perforation occurred at a point of adhesiolysis also involved with Crohn's disease. There were no anastomotic leaks. Median follow-up was 17 months (range, 1–47 months).

Conclusions:

Single-incision laparoscopic ileocecectomy is safe and feasible in pediatric patients with Crohn's disease.