Role of intraoperative enteroscopy for surgical decision making with Crohn's disease.
BACKGROUND
This study aimed to assess the role of intraoperative enteroscopy (IOE) in determining surgical treatment.


METHODS
The IOE procedure was performed for 30 patients with Crohn's disease. The degree of stricture and the presence of active ulcer were examined. Preoperative diagnoses and intraoperative findings obtained by inspection and palpation were noted and compared with the IOE findings.


RESULTS
Of the 78 intestinal strictures observed by IOE (42%), 33 were not found by preoperative examination. Of the 45 strictures confirmed by IOE to be severe (<15 mm in diameter), 8 were judged to be mild (15-25 mm in diameter) or were not even identified by intraoperative inspection and palpation. Active ulcer was found at 12 of 33 mild strictures, and all 12 strictures were surgically corrected. Of 11 severe strictures detected by IOE at previous surgical sites, 9 were found preoperatively, and 4 were judged to be mild on the basis of inspection and palpation. Stricture was found at the ileocecal valve by IOE in seven patients, but was not diagnosed preoperatively in two of these patients.


CONCLUSIONS
Intraoperative enteroscopy provides useful information regarding the status of the lumen in patients with Crohn's disease.
Hotokezaka
M
M
Department of Surgery 1, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
Jimi
S-I
SI
Hidaka
H
H
Maehara
N
N
Eto
T-A
TA
Chijiiwa
K
K
D000328:Adult; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis* / Q000601:surgery; D003657:Decision Making; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome