Quality of life after surgical therapy of small bowel stenosis in Crohn's disease.
BACKGROUND
Improvement in quality of life is one of the important determinants in the treatment of Crohn's disease. Since there is no cure with radical resection of inflamed bowel, strictureplasty has become a useful surgical technique in the treatment of small bowel obstruction. The scope of this study was to define the results of strictureplasty and resection in terms of quality of life, surgical recurrence and postoperative complications.


METHODS
The charts of 67 patients with Crohn's disease of the small bowel were analyzed retrospectively. Patients were treated either by strictureplasty (group A) or resection (group B). Quality of life was evaluated in follow-up examinations using the Inflammatory Bowel Disease Questionnaire (IBDQ).


RESULTS
Postoperative morbidity was 14.8% after strictureplasty and 17% after resection (p = 0.8). 50% of the patients treated by strictureplasty and 37% treated by resection developed recurrent disease (p = 0.40). Quality-of-life measurement revealed no significant difference between patients treated by strictureplasty or resection.


CONCLUSIONS
Results after strictureplasty are comparable to those after resection in terms of complications, recurrence and quality of life in the treatment of small bowel strictures in Crohn's disease. In the long run there might be an advantage for strictureplasty because it prevents complications caused by resectional therapy such as short bowel syndrome.
Broering
D C
DC
Department of General Surgery, University Hospital Eppendorf, University of Hamburg, Germany. broering@uke.uni-hamburg.de
Eisenberger
C F
CF
Koch
A
A
Bloechle
C
C
Knoefel
W T
WT
Izbicki
J R
JR
D000293:Adolescent; D000328:Adult; D002648:Child; D003251:Constriction, Pathologic; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology / Q000523:psychology* / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D018579:Patient Selection; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome