Strictureplasty for ileo-colic anastomotic strictures in Crohn's disease

We report an audit of outcome on 24 patients (16 females) who had a strictureplasty to treat ileo-colic anastomotic strictures. All except one patient had their original resection for Crohn's disease, and required reoperation because of symptoms of recurrent intestinal obstruction for a mean 9.3 months (range 1-36); the remaining patient was discovered to have ileo-colic anastomotic stricture before he underwent laparotomy for closure of loop ileostomy. At operation, four patients needed additional small bowel strictureplasties, two of whom also underwent small bowel resection for separate areas of phlegmonous disease. There was no post-operative mortality, three patients developed wound infection and one had a pelvic abscess, which settled on antibiotic therapy. Two patients have since died of unrelated disease. Five patients have since needed reoperation for recurrence; only one had a stricture at the site of previous strictureplasty. Over a mean follow-up of 70.8 months (range 18-393) all 22 living patients now have complete relief of symptoms.