Abstract
Background. The aim of this study was to review early and late results of strictureplasty for patients affected by Crohn’s disease.Methods. We reviewed 103 patients with obstructive Crohn’s disease undergoing 293 strictureplasties (Heineke-Mikulicz, 235; Finney, 22; Jaboulay, 35; side-to-side isoperistaltic strictureplasty, 1). Mean age at surgery was 31.4 years. Forty-four patients had at least one previous surgery, and synchronous other surgical procedures were performed in 62 patients. For 41 patients with strictureplasty alone, 154 strictureplasties were done. The site and number of strictures treated by strictureplasty were as follows: duodenum (2), small intestine (265), ileocecal region (6), colon (4), recurrence at previous anastomosis (11), and recurrence at previous strictureplasty (5). The mean number of structureplasties per patient was 2.8. Reoperation has been used as the definitive end-point for recurrence, and the long-term outcome of strictureplasty was examined.Results. There was no operative mortality. Septic complications related to strictureplasty developed in 4 patients and reoperation was needed in 2 patients (1.9%). Mean duration of follow-up was 80.3 months. For all patients, the 5- and 10-year reoperation rate was 45.0% and 61.9%, respectively. Forty-five patients (43.7%) required further operation for recurrence, of whom 21 patients (20.4%) had recurrence at the site of strictureplasty, which was restricture in 14 patients and perforating disease in 7 patients. Perforating disease for recurrence was more frequent at the site treated by the Finney or Jabouley procedure compared with Heineke-Mikulicz.Conclusions. It is considered that, in the long term, strictureplasty is safe and useful for preserving the intestine in the surgical treatment of Crohn’s disease if strictures are carefully selected.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Lee ECG, Papaioannou N. Minimal surgery for chronic obstruction in patients with extensive or universal Crohn’s disease. Ann R Coll Surg Engl 1982; 64: 229–33.
Alexander-Williams J, Haynes IG. Conservative operations for Crohn’s disease of the small bowel. World J Surg 1985; 9: 945–51.
Fazio VW, Galandiuk S, Jagelman DG. Strictureplasty in Crohn’s disease. Ann Surg 1989; 210: 621–5.
Fazio VW, Tjandra JT, Lavery IC, Church JM, Milson JW, Oakley JR. Long-term follow-up of strictureplasty in Crohn’s disease. Dis Colon Rectum 1993; 36: 355–61.
Stebbing JF, Jewell DP, Kettlewell MG, Mortensen NJ. Longterm results of recurrence and reoperation after strictureplasty for obstructive Crohn’s disease. Br J Surg 1995; 82: 1471–4.
Yamamoto T, Keighley MRB. Long-term results of strictureplasty without synchronous resection for jejunoileal Crohn’s disease. Scand J Gastroenterol 1999; 34: 180–4.
Michelassi F. Side-to-side isoperistaltic strictureplasty for multiple Crohn’s strictures. Dis Colon Rectum 1996; 39: 345–9.
Michelassi F, Hurst RD, Melis M, Rubin M, Cohen R, Grasparitis A, et al. Side-to-side isoperistaltic strictureplasty in extensive Crohn’s disease. A prospective longitudinal study. Ann Surg 2000; 232: 401–8.
Tjandra JJ, Fazio VW. Strictureplasty without concomitant resection for small bowel obstruction in Crohn’s disease. Br J Surg 1994; 81: 561–3.
Tonelli F, Ficari F. Strictureplasty in Crohn’s disease: surgical option. Dis Colon Rectum 2000; 43: 920–6.
Yamamoto T, Bain IM, Allan RN, Keilley MRB. An audit of strictureplasty for small bowel Crohn’s disease. Dis Colon Rectum 1999; 42: 797–803.
Worsey MJ, Hull T, Ryland L, Fazio VW. Strictureplasty is an effective option in the operative management of duodenal Crohn’s disease. Dis Colon Rectum 1999; 42: 596–600.
Homan WP, Dineen P. Comparison of the results of resection, bypass, and bypass with exclusion for ileocecal Crohn’s disease. Ann Surg 1978; 187: 530–5.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Futami, K., Arima, S. Role of strictureplasty in surgical treatment of Crohn’s disease. J Gastroenterol 40 (Suppl 16), 35–39 (2005). https://doi.org/10.1007/BF02990577
Issue Date:
DOI: https://doi.org/10.1007/BF02990577