The safety and feasibility of laparoscopic redo surgery for recurrent Crohn’s disease: A comparative clinical study of over 100 consecutive patients

Abstract

Background: Despite advances in medical treatments, most patients with Crohn's disease (CD) will still require surgery, with 20%-50% needing redo surgery within 10 years after the primary procedure. There is no consensus on the application of laparoscopic redo surgery for recurrent CD. Methods: This study included 107 patients with CD who underwent surgery from 2012 to 2020 at Osaka University Hospital. All procedures were laparoscopic. Patients were grouped based on whether the surgery was redo or primary for evaluation of the safety and feasibility of laparoscopic redo surgery. Results: The study included 40 patients undergoing redo surgery and 67 having primary surgery. The median age at the time of the procedure was higher for those undergoing redo surgery (43 years vs 34 years, P < 0.0031), as were the duration of CD (16.5 years vs 8.3 years, P < 0.0012) and number of operating minutes (231.0 min vs 169.0 min, P < 0.0001). The remnant bowel length was shorter in the redo surgery group (270.0 cm vs 410.0 cm, P < 0.0001). Rates of open conversion were comparable between the two groups (10.0% vs 3.0%, P = 0.127), as were postoperative complications (32.5% vs 20.9%, P = 0.1812). Conclusions: These results suggest that laparoscopic redo surgery is safe and feasible, with comparable conversion rates and postoperative complications in experienced institutions.