title: Intervention-free interval following strictureplasty for Crohn's Disease.
abstract: BACKGROUND
  Strictureplasty is now well established as a bowel-sparing alternative for surgical treatment of complicated Crohn's disease. Limited resection is still preferred in patients with uncomplicated disease, as subsequent reoperation rates are low.
  
  
  METHODS
  A retrospective review of 26 patients who underwent surgery for small bowel Crohn's disease between 1996 and 2004 was undertaken. A total of 96 small bowel strictureplasties had been performed; 19 patients had strictureplasties performed in isolation, and the remaining 7 patients underwent strictureplasty with concomitant limited resection.
  
  
  RESULTS
  There was no operative mortality. The median follow-up was 41 months. Four patients developed complications that required further surgery. At 41 months, 73.3% of patients undergoing strictureplasty alone and 79.7% undergoing strictureplasty with concomitant resection were intervention-free. If followed up to 70 months or more, the same proportion of patients would remain intervention-free. Four patients developed further recrudescent disease and required surgery: strictureplasty, limited resection, or both. Of these patients, 25% were intervention-free at 41 months.
  
  
  CONCLUSIONS
  Our results show that strictureplasty alone or with concomitant resection can confer intervention-free periods of 41 months or more in 73.3% of patients, suggesting that strictureplasty can be utilized as an alternative to limited resection in uncomplicated Crohn's disease.
authors.affiliation: Department of Colorectal Surgery, St. George's Hospital, Blackshaw Road, London SW17 0QT, UK. proy@sgul.ac.uk
authors.forename: Pratik
authors.initials: P
authors.lastname: Roy
authors.forename: Devinder
authors.initials: D
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003424:Crohn Disease / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation