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Strictureplasty in Crohn's disease.

R E Silverman1, R S McLeod, Z Cohen

  • 1Division of General Surgery, Toronto General Hospital, Ont.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|January 1, 1989
PubMed
Summary

Strictureplasty offers a viable option for managing small bowel Crohn's disease, potentially reducing the need for extensive bowel resection. This surgical technique demonstrated favorable outcomes in a patient cohort, with most remaining asymptomatic post-procedure.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Inflammatory Bowel Disease

Background:

  • Obstructing Crohn's disease of the small bowel often necessitates extensive surgical resection.
  • Strictureplasty presents an alternative approach to manage bowel obstruction while preserving bowel length.

Purpose of the Study:

  • To evaluate the efficacy and safety of strictureplasty in patients with obstructing Crohn's disease.
  • To assess the impact of strictureplasty on the extent of bowel resection and patient outcomes.

Main Methods:

  • The study involved 14 patients undergoing 16 operations with a total of 36 strictureplasties.
  • Additional bowel resection was performed in 13 of the 16 procedures.
  • Early complications and long-term follow-up (mean 16.1 months) were recorded.

Main Results:

  • Ten out of 14 patients remained asymptomatic at the end of the follow-up period.
  • Four patients experienced symptomatic recurrences, with two requiring reoperation.
  • Early complications included wound infection, upper gastrointestinal bleeding, and a presumed suture-line leak.

Conclusions:

  • Strictureplasty is a potentially effective procedure for obstructing small bowel Crohn's disease, often combined with limited resection.
  • The technique can lead to favorable long-term outcomes, although recurrence is possible.
  • Preoperative factors and surgical techniques likely influence the success of strictureplasty.

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