Robotic Redo Ileocolonic Resection for Crohn's Disease: A Preliminary Report From a Tertiary Care Center

BACKGROUND: Although the safety of laparoscopic redo ileocolonic resection for Crohn's disease has been described before, the safety of robotic redo ileocolonic resection is still unelucidated. OBJECTIVE: This study aimed to share our preliminary experience regarding the safety of robotic redo ileocolonic resection for Crohn's disease. DESIGN: Retrospective analysis. SETTING: Tertiary care center. PATIENTS: All consecutive adult patients who underwent robotic ileocolonic resection for Crohn's disease at our institution between 2014 and 2021 were included. Patients were divided into redo ileocolonic resection and primary ileocolonic resection groups. PRIMARY OUTCOME MEASURES: Baseline demographics, preoperative risk factors, and intraoperative details were compared between both groups. The primary outcome was conversion to an open approach, and secondary outcomes were 30-day postoperative complications. RESULTS: A total of 98 patients were included. Of them, 18 (18.4%) had a redo ileocolonic resection. Patients who had a redo ileocolonic resection were more likely to have a longer duration of disease, associated anoperineal disease, a higher number of previous lines of medical treatments, received total parental nutrition before the operation for correction of malnutrition, and longer time for adhesiolysis. Patients who had redo ileocolonic resection had a higher risk for conversion to open ileocolonic resection [3 (16.7%) versus 2 (2.5%); p value = 0.04]. There was no statistically significant difference regarding the overall length of stay and the 30-day morbidity between both groups. No 30-day mortality or anastomotic leaks occurred in either group. LIMITATIONS: Retrospective nature of the analysis. CONCLUSIONS: Robotic redo ileocolonic resection showed similar short-term postoperative outcomes to robotic primary ileocolonic resection for Crohn's disease. However, conversion rates are higher in robotic redo ileocolonic resection yet seem lower than previously published results in laparoscopic surgery.

Automated summary

This study retrospectively analyzed the safety of robotic redo ileocolonic resection in 98 patients with Crohn's disease. Patients who underwent redo ileocolonic resection had longer disease duration, more associated anoperineal disease, more previous lines of medical treatments, more frequent use of total parental nutrition before surgery for malnutrition correction, and longer adhesiolysis time. The risk of conversion to open ileocolonic resection was higher in the redo group. There were no significant differences in length of stay and 30-day morbidity between the two groups. No mortality or anastomotic leaks occurred in either group.