Factors that predict conversion in patients undergoing laparoscopic surgery for Crohn's disease

Abstract 

Background

To identify factors that would predict conversion in patients undergoing laparoscopic surgery for Crohn's disease.

Methods

Data were collected retrospectively. All procedures were performed by an experienced laparoscopic surgeon.

Results

Forty-eight patients underwent 57 laparoscopic procedures. Twenty-six of these procedures were for recurrent disease. The conversion rate was 42.3% (11 of 26) for recurrent disease and 13% (4 of 31) for primary disease. On univariate analysis age (P = 0.02), surgery for recurrence (P = 0.02), time from diagnosis (P = 0.03), and the presence of a clinical mass (P = 0.03) were factors that predicted conversion. On multivariate analysis these factors except time from diagnosis still remained significant. Patients who did not undergo a conversion had significantly better post operative outcomes. There was no difference in the incidence of major or minor complications or the number of resections in both groups.

Conclusions

The conversion rate for the whole group was 28%. The rate is higher in patients who are over 40 years of age who are undergoing procedures for recurrence.

Keywords:  Laparoscopic surgery, Crohn's disease, Inflammatory bowel disease, Colorectal surgery