Strictureplasty in Crohn's disease: short- and long-term follow-up.
Strictureplasty for obstructive Crohn's disease is still controversial because lesions are left in place and the suture is performed on a diseased bowel. Many surgeons prefer to perform bowel resection, hoping for fewer complications and a lower recurrence rate. In this paper, the authors reports their strictureplasty experience. They performed a systematic retrospective review of the patients suffering from Crohn's disease who underwent strictureplasties during a 10-year period in the abdominal surgery department of the University Hospital of Liège Sart Tilman, and studied the short- and long-term clinical results of 68 strictureplasties performed in 18 patients. Median follow-up was 63 months (range 12 to 144). Mortality was 0% and septic morbidity was 11% (one wound abscess and one leakage). Among the 16 patients available for the latest follow-up, symptomatic stenotic recurrence had to be medically treated in hospital for 4 patients (25%) with a recurrence delay range of 19 to 49 months. Stenosis recurrence needed re-intervention in one patient 48 months after surgery: stenosis occurred at a distance from the corrected site. These results confirmed that strictureplasty is a safe and efficient procedure in selected patients undergoing surgery for obstructive Crohn's disease.
Laurent
S
S
Dpt of Abdominal Surgery, CHU Sart Tilman B-35, Liège, Belgium.
Detry
O
O
Detroz
B
B
DeRoover
A
A
Joris
J
J
Honoré
P
P
Louis
E
E
Belaïche
J
J
Jacquet
N
N
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007420:Intestine, Large / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome