Is laparoscopy the gold standard for inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease?
It is not actually. I think that you are talking about the surgical treatment of the disease. Certainly is a growing number of indications of laparoscopic treatment instead of open surgery
Laparoscopy is not the preferred surgery in CD complication, especially for strictureplasty and intestinal resection. Laparoscopic IPAA with J pouch in UC is feasible in some excellence centers with good outcomes, this technique may be preferred in younger patients.
Imay be yes , may be no . It depends on the nature and course of the disease , the laparocopy center work load ...., it‘s not yet the gold standard to do such surgery .
thank you
Gold standard for diagnosis of IBD is colonoscopy for both diseases and especially terminal ileoscopy due to main localisation of Crohn diseses in this region. Laparascopy has role in operative indication such as laparascopic total colectomy.
I agree with my colleagues that colonoscopy is the gold standard technique to follow-up correctly to these patients
I think actually we dont have a gold standar for diagnosis IBD, because any of the studies ( endoscopy, colonoscopy, serum biomarcher, event the biopsy) dont have a high sensivity or specificity. So the best way to diagnosis IBD its taking in count the clinic of the patient with the results of the studies with more relevance.
Answering the question, laparoscopy cannot see the mucous membranes of the bowel, so the positive predictive value to diagnosis IBD its low.
Zaim what is the PPV of biopsies in IBD ? Because if we talk about pathognomonic its because they are very sensitive and specific... The 2016 Crohn disease ECCO Guidelines are clear about that:
" ECCO statement 2B A single gold standard for the diagnosis of CD is not available. The diagnosis is confirmed by clinical evaluation and a combination of endoscopic, histological, radiological, and/or biochemical investigations. Genetic or serological testing is currently not recommended for routine diagnosis of CD [EL5]"
Normally. But central role in this diagnostic tool is endoscopic and bioptic findings.
I would agree with some of the earlier responses. No, laparoscopy is not the gold standard. The diagnosis takes into consideration the clinical presentation, labs, and endoscopy...
Hi colleagues ,
Laparoscopy is not the gold standard for the diagnosis of IBD , yet it could be helpful in its managment in experienced centers .
Thanks