Short- and long-term outcomes of laparoscopic surgery for intestinal Behcet's disease: a comparative study with open surgery.

ABSTRACT

INTRODUCTION: Surgical treatment of intestinal Behcet's disease (BD) is not well established. Specifically, it is still difficult to assess the clinical value of laparoscopic surgery to address this condition. We aimed to evaluate the clinical course and the characteristics of laparoscopic surgery for intestinal BD compared with open surgery. METHODS: We reviewed charts of 91 patients who underwent surgical treatment for intestinal BD between January 1995 and December 2012. We retrospectively compared the laparoscopic group (LG, n = 30) and the open group (OG, n = 61) in terms of patient demographics, clinical features, operative data, postoperative course, complications within 30 days after operation, and long-term follow-up data. RESULTS: There were more females in the LG than in the OG (63.3 vs. 36.1%, p = 0.014), and oral/genital ulcers were more frequent in the LG (76.7 vs. 54.1%, p = 0.038; 60 vs. 36.1%, p = 0.031). Intractability with medical treatment was dominant in the LG (76.7 vs. 45.9%, p = 0.02), while intestinal perforation or fistula were more prevalent in the OG (10 vs. 44.3%, p = 0.001). Most patients received an ileocecectomy or a right hemicolectomy as their first surgery. In the LG, the patients had a shorter operation time (162.0 vs. 228.5 min, p < 0.001) and had less blood loss (61.7 vs. 232.3 ml, p = 0.003). There were no significant differences in postoperative complications, reoperation, mortality, and hospital stay between the groups. During the follow-up period, the mean number of operations was less in the LG than in the OG (1.3 vs. 2.1, p = 0.011). Analysis indicated that 20% of patients in the LG and 50.8% in the OG underwent more than two operations (p = 0.005). CONCLUSION: Laparoscopic surgery is feasible and safe for selected intestinal BD patients. However, there were no better short-term outcomes in LG compared with OG.