title: Strictureplasty for Treatment of Crohn's Disease: an ACS-NSQIP Database Analysis.
abstract: BACKGROUND
  Strictureplasty is an alternative to resection for treatment of Crohn's disease (CD) strictures. It preserves bowel length, and specialized centers report favorable outcomes. Strictureplasty rates, however, are thought to be low, and it was recently removed from required cases for colon and rectal surgery residents. We examined operative characteristics, and trends in its use using a large national database.
  
  
  METHODS
  We examined the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2012, identifying patients with CD who underwent strictureplasty. We identified patient characteristics, outcome variables, and trends in utilization of strictureplasty.
  
  
  RESULTS
  A total of 9172 patients underwent surgery for CD. Two hundred fifty-six (2.8 %) underwent strictureplasty. Median preoperative albumin was 3.6. Preoperative steroid use and weight loss rates were 39 and 8 %. Rates of wound infection and organ space infection were 11 and 4 %. Rate of reoperation was 6 %. Outcomes did not change significantly over time (all p = NS). The proportion of CD operations that included a strictureplasty decreased from 5.1 to 1.7 % (OR 0.902 with each additional year, 95 % CI (0.852, 0.960), p < 0.001).
  
  
  CONCLUSIONS
  Strictureplasty as treatment for CD is decreasing in the ACS-NSQIP database. Infectious complications and reoperation rates following strictureplasty are low and have not changed over time.
authors.affiliation: Department of Surgery, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Mail Code L223A, Portland, OR, 97239, USA, budde@ohsu.edu.
authors.forename: Cristina B
authors.initials: CB
authors.lastname: Geltzeiler
authors.forename: J Isaac
authors.initials: JI
authors.lastname: Young
authors.forename: Brian S
authors.initials: BS
authors.lastname: Diggs
authors.forename: Kian
authors.initials: K
authors.lastname: Keyashian
authors.forename: Karen
authors.initials: K
authors.lastname: Deveney
authors.forename: Kim C
authors.initials: KC
authors.lastname: Lu
authors.forename: V Liana
authors.initials: VL
authors.lastname: Tsikitis
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Herzig
mesh_terms: D000328:Adult; D003106:Colon / Q000473:pathology* / Q000601:surgery*; D003251:Constriction, Pathologic / Q000601:surgery; D003424:Crohn Disease / Q000473:pathology* / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D024162:Second-Look Surgery; D016896:Treatment Outcome