Introduction Single-incision laparoscopic surgery (SILS) aims to minimize the surgical access trauma by reducing the
number of abdominal incisions to a single site, potentially offering better cosmetic results and decreased postoperative
pain. In this study, we compare the results of SILS ileocolic resection for Crohn’s disease (CD) to conventional
laparoscopy and open surgery using a propensity score–matched analysis in a retrospective national
multicentre study.
Methods All consecutive patients undergoing elective SILS ileocaecal or redo ileocolic resection for primary and recurrent
CD from 1 June 2018 to 31 May 2019 were included. Patients were matched 1:1:1 with laparoscopy and open surgery
according to perianal disease, recurrent disease, penetrating phenotype of CD, history of previous abdominal surgery,
preoperative medical treatment with steroids and anti-TNF. Postoperative morbidity within 30 days of surgery was the
primary endpoint.
Results Fifty-eight patients were included in each group, for a total of 174 patients. The conversion rate for SILS and laparoscopy
was 10.3%and 12%, respectively, with no difference in the incidence of postoperative complications (13.8% and 12%, p = 0.77),
whilst open surgery demonstrated a worse morbidity profile, with a complication rate of 25.9% (p < 0.0001). Median length of
hospital stay following SILS ileocolic resection was 5 days, significantly shorter compared to 7 days for laparoscopy and 9 for
open surgery (p < 0.0001).
Conclusions SILS ileocolonic resection for CD demonstrated a comparable morbidity profile compared to laparoscopy in
selected patients, with a reduced length of postoperative hospital stay.
