Outcomes of Laparoscopic Versus Open Surgery in the Treatment of Complications of Penetrating Crohn’s Disease: A Systematic Review
DOI:
https://doi.org/10.56294/saludcyt20252220Keywords:
Crohn Disease, Laparoscopy, Laparotomy, Postoperative Complications, Surgical Procedures, Operative, Treatment OutcomeAbstract
Background:
Penetrating Crohn’s disease (CD) frequently results in fistulas, abscesses, or strictures, requiring surgery in up to 70% of cases. While laparoscopic surgery (LS) is well established in elective CD, its role in penetrating disease remains uncertain due to technical challenges and variable outcomes compared with open surgery (OS).
Methods:
We conducted a systematic review following PRISMA guidelines. Comparative studies (retrospective cohorts, propensity-matched analyses, randomized controlled trials, and meta-analyses) were identified through multiple databases. Primary outcomes included perioperative complications, wound infection, incisional hernia, postoperative pain, hospital stay, and disease recurrence.
Results:
Eight studies were included. LS was associated with reduced perioperative complications (RR 0.71, p = 0.001), lower incisional hernia risk (RR 0.24, p = 0.02), and shorter hospital stay (5 vs. 8 days, p < 0.05). Conversion to OS occurred in 10–25% of cases due to disease extent. Long-term recurrence rates were comparable between LS and OS (30% at 5 years; 60% at 10 years).
Conclusion:
LS provides superior short-term outcomes over OS in penetrating CD, with fewer complications and faster recovery. Long-term disease control is equivalent, and outcomes depend strongly on patient selection and surgical expertise in managing complex disease.
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Copyright (c) 2025 Dario Javier Caguate Miranda, Andrea Cristina Palacios Barahona, Diego Mateo Murgueytio Aguilar, Julio Felipe Larreátegui Espinosa, Paola Angeline Arcos Vásconez, Franklin Marcelo Noboa ibarra, González Mercado Zeus Edrian Daniel Alfonso (Author)
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