Metaanalysis of trials comparing laparoscopic and open surgery for Crohn's disease

Background: Several studies in the literature have suggested that laparoscopic surgery for Crohn's disease is associated with faster postoperative recovery and a morbidity and recurrence rate similar to that for open surgery. Most of these studies have been limited by a small sample size and a short follow-up period. Methods: To clarify whether open or laparoscopic resection results in a better outcome, a metaanalysis of studies was performed comparing the two procedures for Crohn's disease. Pooled effects were estimated using a random-effects model. Results: Laparoscopic surgery required more operative time than open surgery (26.8 min; 95% confidence interval [CI], 6.4-47.2 min), but resulted in a shorter duration of ileus and a decreased hospital stay (-2.62 days; 95% CI, -3.62 to -1.62). Laparoscopic surgery also was associated with a decreased rate for postoperative bowel obstruction and surgical recurrences. Conclusions: Laparoscopic surgery for Crohn's disease is feasible, safe, and associated with shorter duration of ileus and a shorter hospital stay.