LAPAROSCOPY IN THE DIAGNOSIS OF CROHN’S DISEASE AND LITERATURE REVIEW

I. Slavu; L. Alecu; V. Braga; Nicoleta Băjenaru; Daniela Mihăilă; S. Constantinoiu

doi:10.33695/jss.v4i4.217

I. Slavu General Surgery Clinic, Emergency Clinical Hospital “Professor Doctor Agrippa Ionescu”, Bucharest, Romania
L. Alecu General Surgery Clinic, Emergency Clinical Hospital “Professor Doctor Agrippa Ionescu”, Bucharest, Romania
V. Braga General Surgery Clinic, Emergency Clinical Hospital “Professor Doctor Agrippa Ionescu”, Bucharest, Romania
Nicoleta Băjenaru General Surgery Clinic, Emergency Clinical Hospital “Professor Doctor Agrippa Ionescu”, Bucharest, Romania
Daniela Mihăilă General Surgery Clinic, Emergency Clinical Hospital “Professor Doctor Agrippa Ionescu”, Bucharest, Romania
S. Constantinoiu General Surgery Clinic, “Saint Mary” Hospital, Bucharest, Romania

DOI: https://doi.org/10.33695/jss.v4i4.217

Keywords: Crohn disease, laparoscopy treatment Crohn disease

Abstract

Crohn's Disease is a dilemma from a surgical point of view. The nature of the pathology increases the technical complexity of surgical interventions, their morbidity and the incidence of reintervention. In this context, the advantages of minimally invasive surgery such as reduced hospitalization, fewer adhesions, the low incidence of wound complications, the faster return to normal intestinal function are of particular importance to these patients. This pathology that requires interventions in an elective context may in most cases be initially approached laparoscopically. Observatory sheets, operative protocols, and in some cases video recordings, were reviewed retrospectively over a period of 20 years (January 1997 - January 2017), bearing in mind indications, contraindications, difficulties and complications encountered. The literature on the minimal invasive approach to the treatment of Crohn’s disease has also been reviewed by accessing medical databases (SCOPUS, PUBMED). The mean age of the study group was 40 years with female sex predominance. The main surgical indication was abdominal algic syndrome and intestinal transit disorders. For all patients, the diagnosis resulted from laparoscopy surgery - by macroscopic appearance of intestinal lesions and lymphatic tissue biopsy, with the clear majority of patients presenting mesenteric adenopathies during inflammatory attacks. The intestinal transit resumed on average on day 2 postoperatively and the duration of hospitalization was on average of 4 days. There were no intraoperative or postoperative incidents. Mortality was 0. Laparoscopic surgery combines many benefits for the patient with Crohn's disease, all of which eventually lead to a lower cost of care and a less hostile abdomen in the case of other interventions. These patients, through the anti-inflammatory treatment (steroids), fragile tissues, and abdominal adhesions complicate laparoscopic surgery - so it should only be attempted by experienced surgeons.