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Strictureplasty for obstructive Crohn's disease: the Mayo experience
M P Spencer1, H Nelson, B G Wolff
1Department of Surgery, Mayo Clinic, Rochester, MN 55905.
Mayo Clinic Proceedings
|January 1, 1994
Summary
Strictureplasty is a safe and effective surgical option for obstructive Crohn's disease, preserving bowel length. This procedure showed low complication rates and allowed patients to discontinue medical treatments.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Inflammatory Bowel Disease Research
Background:
- Crohn's disease frequently causes small bowel obstruction.
- Strictureplasty is an emerging surgical technique for managing obstructive Crohn's disease.
- The optimal use cases for strictureplasty require further clinical definition.
Purpose of the Study:
- To evaluate the safety and efficacy of strictureplasty in patients with Crohn's disease.
- To determine the outcomes of strictureplasty in a clinical setting.
- To assess the recurrence and reoperation rates following strictureplasty.
Main Methods:
- A retrospective review of 244 patients undergoing abdominal exploration for Crohn's disease complications.
- Analysis of 35 patients who underwent 71 strictureplasties between 1985 and 1991.
- Inclusion of concomitant bowel resection in 67% of strictureplasty procedures.
Main Results:
- No perioperative deaths, anastomotic leaks, enteric fistulas, or intra-abdominal abscesses were observed.
- The overall perioperative complication rate was 14%.
- 33 of 35 patients resumed enteral nutrition and discontinued medical therapy; 20% recurrence rate at 3 years.
Conclusions:
- Strictureplasty is a viable option for treating isolated, quiescent, stenotic lesions in Crohn's disease.
- The procedure demonstrates favorable short-term outcomes and allows for medical treatment cessation.
- Further research may refine patient selection for optimal strictureplasty outcomes.