Analysis of the efficacy and safety of laparoscopic surgery for penetrating Crohn's disease
WEN Ming
SUN Zhen-ya
FENG Deng-yu
DUAN Ming
LI Yi
ZHU Wei-ming
Abstract：Objective To investigate the safety of laparoscopic surgery for penetrating Crohn's disease(CD)and its long-term clinical outcomes.Methods A retrospective analysis was conducted on the clinical data from 238 patients with penetrating CD who underwent partial intestinal resection at the Department of General Surgery,Jinling Hospital Affiliated to Nanjing University Medical School,between January 2018 and December 2022.Patients were divided into laparoscopic and open surgery groups based on surgical approach.After propensity score matching(PSM),short-term complication rates and long-term recurrence rates were compared between the two groups.Cox regression analysis was used to identify risk factors influencing recurrence.Results After PSM,124 patients with penetrating CD were included,with 62 patients in each group.After PSM,there was no statistically significant difference in the preoperative baseline data between the two groups of patients(P＞0.05).For short-term outcomes,the laparoscopic group had lower rates of incisional infection(4.8％vs.16.1％,x2=4.210,P=0.040)and infectious complications(11.3％vs.27.4％,x2=5.170,P=0.023)compared to the open surgery group,with statistically significant differences.For long-term outcomes,the laparoscopic group demonstrated lower endoscopic recurrence(x2=4.25,P=0.039)and surgical recurrence rates(x2=4.49,P=0.035),with statistically significant differences.Multivariate Cox regression analysis identified laparoscopic surgery(HR=0.53,95％CI 0.28-0.90,P=0.047)as an independent protective factor against endoscopic recurrence.Laparoscopic surgery(HR=0.16,95％CI 0.03-0.90,P=0.038)and hemoglobin level(HR=0.94,95％CI 0.89-0.99,P=0.018)were independent protective factors against surgical recurrence.Conclusion Laparoscopic surgery is safe and feasible for penetrating CD and offers advantages in reducing long-term postoperative recurrence.It can serve as an effective treatment option for penetrating CD.
Keywords：penetrating Crohn's diseaselaparoscopic surgeryshort-term complicationsurgical recurrenceendoscopic recurrence
Publication Date：2025-05-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 582-588 )