title: Long-term follow-up of strictureplasty in Crohn's disease.
abstract: Strictureplasty is an alternative to extensive and/or multiple small bowel resections in the surgical treatment of Crohn's disease. We here report a series of 22 patients (12 M-10 F-mean age years 28). All patients had non perforative form of Crohn's disease lasting for a mean of 8 years. Nine out of 22 had previous intestinal resections. A total of 201 stenosis was identified during per-operative examination (mean per patient: 9). Only tight stenoses (diameter < 2 cm) were treated while others were left untouched. Eighty-three stenoses were treated by short strictureplasty and 24 by long strictureplasty using steel thread. One or several resections were simultaneous performed in 15 patients. Mortality was nil. A post operative abscess without loosened suture was drained. The mean follow-up in the 22 patients was 36 months (range: 12 to 96). Relief of obstructive symptoms was achieved in all patients. Symptomatic recurrence occurred in 9 patients (40%) and 5 (22%) needed reoperation. In one case haemorrhagic ulceration developed within a long strictureplasty and in 4 others stenosis developed in plasty areas but also in previous healthy areas. Thus stricture-plasty is intended not to replace resection but rather to serve as a useful adjunct to the existing surgical options in the treatment of Crohn's disease, especially when short bowel syndrome is a consideration.
authors.affiliation: Clinique Chirurgicale Ouest, C.H.R.U., Lille.
authors.forename: P
authors.initials: P
authors.lastname: Quandalle
authors.forename: L
authors.initials: L
authors.lastname: Gambiez
authors.forename: J F
authors.initials: JF
authors.lastname: Colombel
authors.forename: J C
authors.initials: JC
authors.lastname: Paris
authors.forename: A
authors.initials: A
authors.lastname: Cortot
mesh_terms: D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome