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[Stricture plasty in Crohn's disease. Indications and results]
A Resegotti1, M Astegiano, R Sostegni
1Dipartimento Medico-Chirurgico delle Malattie dell'Apparato Digerente e della Nutrizione, Azienda Ospedaliera, S. Giovanni Battista, Torino.
Background:
Aim of the paper is to evaluate the indications and results of stricture plasty in the treatment of intestinal obstruction due to Crohn's disease. It is hypothesized that, as far as fibrotic strictures are treated, operative morbidity will be reduced to a minimum.
Methods:
Data regarding 147 interventions for Crohn's disease performed in a 4.5 year-period have been prospectively collected. Eight interventions including stricture plasty have been identified and indication, morbidity and end results analyzed.
Results:
In 8 interventions 20 stricture plasties have been performed. As a rule, a stricture plasty is performed only when a resection would have sacrificed a too long bowel tract or it was inappropriate, in relation to stricture site. Three patients had fistulae, but those fistulae were not in the same site of stricture plasty and only one patient was malnourished and with active disease. There was no operative mortality or major morbidity, but there was only a short episode of hyperthermia. No relapses were observed after a 26-month mean follow-up.
Conclusions:
Stricture plasty is a useful tool in order to avoid extensive intestinal resections. If it is performed only on fibrotic strictures with inactive disease and only if a resection is deemed inappropriate, minimal morbidity and very good results can be anticipated.