TY - JOUR T1 - Advantages of laparoscopic resection for ileocolic Crohn's disease. Improved outcomes and reduced costs. AU - Young-Fadok,T M, AU - HallLong,K, AU - McConnell,E J, AU - Gomez Rey,G, AU - Cabanela,R L, Y1 - 2001/04/03/ PY - 2000/06/15/received PY - 2000/11/14/accepted PY - 2001/5/17/pubmed PY - 2001/9/21/medline PY - 2001/5/17/entrez SP - 450 EP - 4 JF - Surgical endoscopy JO - Surg Endosc VL - 15 IS - 5 N2 - BACKGROUND: Laparoscopic colorectal procedures are considered to be technically challenging, and there is a lack of consensus regarding the magnitude of their benefits. The laparoscopic approach is generally held to be more expensive. Using a model of a single procedure performed for a single indication (ileocolic resection for Crohn's disease [CD]), we set out to demonstrate the feasibility of this procedure by determining the conversion rate, documenting the patient benefits, and performing a formal cost analysis. METHODS: Consecutive cases of laparoscopic ileocolic resection for CD were identified (LAP). Case-match methodology identified a series of open laparotomy controls (OPEN) that were matched for five potential confounding criteria: age, gender, diagnosis, type of resection, and date of operation. Pre-, intra-, and postoperative details were gathered. Medical resource utilization was tracked using a standardized database, and all costs were reported in 1999 dollars. RESULTS: The conversion rate was 5.9%. Resolution of ileus occurred more rapidly in the LAP than in the OPEN group. The time to clears in the LAP group was a median of 0 days (range, 0-4) vs 3.0 days (range, 2-8) in the OPEN group (p = 0.0001). Time to regular diet was 2.0 days (range, 1-6) in the LAP group vs 5.0 days (range, 3-12) in the OPEN group (p = 0.0001). Length of hospital stay was significantly reduced in the LAP group (4.0 days [range, 2-8], vs 7.0 days [range, 3-14], p = 0.0001). The LAP group had significantly lower direct costs ($8684 vs $11,373) and indirect costs ($1358 vs $2349) than the OPEN group (p < 0.001). This resulted in total costs of $9895 for LAP vs $13,268 for OPEN (p < 0.001). CONCLUSION: Laparoscopic ileocolic resection for CD is feasible. There are significant postoperative benefits in terms of resolution of ileus, narcotic use, and hospital stay. This approach translates into cost savings of >$3300 for laparoscopic patients. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/11353959/full_citation DB - PRIME DP - Unbound Medicine ER -