title: Strictureplasty and intestinal resection: different options in complicated pediatric-onset Crohn disease.
abstract: OBJECTIVE
  Surgical resection or strictureplasty (SP) are different options for intestinal Crohn disease (CD) strictures. The aim of this article is evaluation of long-term outcome of SP and resection.
  
  
  METHODS
  From 1996 to 2011, 39 patients (23 male, 16 female) with symptomatic ileal and ileocolonic CD strictures resistant to medical/nutritional therapy and treated with surgery in 2 different surgical units were reviewed. The mean age at diagnosis was 11.82 years (range, 4-17 years). Mean age at surgery was 15.94 years (range, 4-24 years). Mean follow-up was 6.88 years (range, 0.5-15 years). Patients underwent resection (group A) or different SP techniques (group B).
  
  
  RESULTS
  Twenty patients underwent intestinal resection (ileal or ileocolonic resection), and 19 patients underwent SP (jejunal, ileal, or ileocolic). Early postsurgical complications were observed in 2 patients of group A. Follow-up of group A patients revealed that 1 patient needed emergency treatment after 8 months surgery because of adhesions and 1 patient developed recurrence treated with medical therapy. In the follow-up group B, 3 patients experienced disease recurrence, 2 of them at the site of previous surgery.
  
  
  CONCLUSIONS
  At long-term follow-up, no significant difference in relapsing rate was observed between the 2 groups. Strictureplasty and resection represent an effective treatment of pediatric CD strictures. Strictureplasty could represent the first option for intestinal preservation.
authors.affiliation: Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome 00165, Italy. erminia.romeo@gmail.com
authors.forename: Erminia
authors.initials: E
authors.lastname: Romeo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Jasonni
authors.forename: Tamara
authors.initials: T
authors.lastname: Caldaro
authors.forename: Arrigo
authors.initials: A
authors.lastname: Barabino
authors.forename: Girolamo
authors.initials: G
authors.lastname: Mattioli
authors.forename: Stefania
authors.initials: S
authors.lastname: Vignola
authors.forename: Giovanni Federici
authors.initials: GF
authors.lastname: di Abriola
authors.forename: Paola
authors.initials: P
authors.lastname: De Angelis
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pane
authors.forename: Filippo
authors.initials: F
authors.lastname: Torroni
authors.forename: Francesca
authors.initials: F
authors.lastname: Rea
authors.forename: Luigi
authors.initials: L
authors.lastname: Dall'Oglio
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000601:surgery*; D007082:Ileum / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult