Keywords
Laparoscopy
Open surgery
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Abstract
Objective: To compare laparoscopy with open surgery in the management of complicated Crohn’s disease. Method: This is a systematic review conducted in accordance with PRISMA recommendations, with a protocol registered in PROSPERO (CRD420261340757). The search was performed in the PubMed/MEDLINE, BVS, and Portal Capes databases, considering studies published in the last 10 years and available in full text. Study selection was carried out by three independent reviewers, and methodological quality was assessed using the Newcastle–Ottawa Scale. Results: Predominantly observational studies with good methodological quality were included. Laparoscopy showed shorter hospital stay, lower incidence of infectious complications, and faster recovery compared to open surgery. Overall complication and mortality rates were similar. However, a higher conversion rate was observed in more complex cases, such as recurrent and fistulizing disease, in addition to high morbidity associated with disease extent and the type of procedure performed. Final considerations: Laparoscopy is a safe and effective alternative in the treatment of complicated Crohn’s disease, with consistent advantages in postoperative recovery. However, its applicability should be individualized, considering case complexity and team experience, while open surgery remains an essential approach in specific situations.
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