Minimally invasive ileocecal valve resection in ileocecal Crohn’s disease

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COD: 11_2022_3815-1 Categorie: ,

Giacomo Benassai, Carlo Serra, Gregorio Romeo, Francesca Calemma, Francesco Maione, Mariarosaria Portinaio, Marianna Scevola, Gianluca Benassai, Gennaro Quarto

Ann. Ital. Chir., 2022 93, 6: 680-688

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AIM: Considering ileocolic resection as a surgical standard for the treatment of ileocecal valve Crohn’s disease, we propose a limited resection of the terminal ileum and ileocecal valve with ileocecal anastomosis.
Material of Study: Three patiens between 20 and 37 years of age, diagnosed with Crohn’s disease unresponsive to medical therapy, who have stenoses or fissures confined to the terminal ileum and ileocecal valve, seen during instrumental investigations.
RESULTS: The proposed procedure allowed us to perform a minimal resection and reconstruction of a new ileocecal valve. Once the symptoms have resolved, at endoscopic follow ups, at 6 and 12 months after surgery, there were no changes in the mucosa of the ileocecal neo-anastomosis.
DISCUSSION: Since Crohn’s disease is a systemic disease with a chronic relapsing course complicated by a high rate of post-surgical relapses, it is essential to limit the extension of resections to the macroscopically involved tissues and reduce the anastomotic surfaces. The proposed surgical procedure allows to preserve the caecum and the colon with an optimal postoperative course.
CONCLUSION: We believe that, with specific clinical and endoscopic conditions, the treatment we illustrated can be proposed to other patients as an alternative to the standard VL ileocolic resection.