Meta-analysis of laparoscopic surgery for recurrent Crohn's disease.

PURPOSES

It remains unclear whether laparoscopic surgery is suitable for recurrent Crohn's disease (CD). The objective of this meta-analysis was to evaluate the safety and feasibility of laparoscopic resection for recurrent vs. primary CD by comparing intraoperative and postoperative outcomes.

METHODS

We searched the PubMed and Cochrane Library databases for studies that compared complications associated with laparoscopic resection for primary and recurrent CD. The primary study endpoints were conversion rates and postoperative complication rates.

RESULTS

Seven trials with a collective total of 627 participants (413 with primary CD and 214 with recurrent CD) met our inclusion criteria. Laparoscopic resection was associated with a significantly higher conversion rate when performed for recurrent CD than for primary CD (OR = 2.53; 95 % CI 1.22-5.25; p = 0.01). However, there was no significant difference in the total complication rate between laparoscopic resection for primary vs. that for recurrent CD (OR = 1.41; 95 % CI 0.86-2.34; p = 0.18).

CONCLUSIONS

Although a higher conversion rate suggests technical complexity, laparoscopic resection for recurrent CD is considered a safe and feasible procedure, without an increased risk of postoperative complications.