A prospective, longitudinal study of nonconventional strictureplasty in Crohn’s disease1

Sampietro, Gianluca; Cristaldi, M.; Maconi, Giovanni; Parente, F.; Sartani, A.; Ardizzone, Sandro; Danelli, Piergiorgio; Porro, G. Bianchi; Taschieri, A.M.

doi:10.1016/j.jamcollsurg.2004.01.039

Cited by 59 publications

(49 citation statements)

References 50 publications

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“…The effectiveness of postoperative enteral hyperalimentation may have played a role as well. The effi cacy of ED as primary treatment has been well established in Japan since 1993, 14 and approximately 60% of the present patients were treated with ED. However, decreases in long-term ED compliance are likely, because ED is unpalatable and restricts social activities, and the patients must restrain their appetite, while it increases again when the disease activity worsens.…”

Section: Discussionmentioning

confidence: 90%

“…Strictureplasty (SP) is an established surgical option for management of obstructive CD, 7 with a number of reports showing its safety and effi cacy, as well as its particular suitability for patients at risk of developing short bowel syndrome. 6,[8][9][10][11][12][13][14] The number of patients with CD has been increasing in both Japan and Western countries. Although most patients are now well controlled by nutritional treatment such as ED in Japan, a large number require surgical treatment for various complications.…”

Section: Introductionmentioning

confidence: 99%

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Long-term efficacy of strictureplasty for Crohn’s disease

et al. 2010

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Long-term efficacy of strictureplasty for Crohn’s disease

et al. 2010

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“…It has been clearly shown that CD strictures can be treated by strictureplasty instead of resection [19][20][21][22][23][24][25][26] . The regression of inflammatory activity of CD at the strictureplasty site has been well documented by radiological, ultrasonographic, endoscopic or histological investigations [27][28][29][30][31] .…”

Section: Discussionmentioning

confidence: 99%

Is lymphatic status related to regression of inflammation in Crohn's disease?

Tonelli

Giudici²,

Liscia³

2012

WJGS

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AIM:To investigate the status of the lymphatic vessels in the small bowel affected by Crohn's disease (CD) at the moment of surgery. METHODS:During the period January 2011-June 2011, 25 consecutive patients affected by CD were operated on in our Institution. During surgery, Patent Blue Ⅴ was injected subserosally and the way it spread along the subserosa of the intestinal wall, through the mesenterial layers towards the main lymphatic collectors and eventually to the lymph nodes was observed and recorded. Since some patients had been undergone strictureplasty at previous surgery, we also examined the status of intestinal lymph vessels after previous strictureplasties. The same procedure was performed in a control group of 5 patients affected by colorectal cancer. Length of lesions, caliber, maximal thickness of the diseased intestinal wall, thickness of the wall at injection site and thickness of the mesentery were evaluated at surgery. RESULTS:We observed three features after the injection of Patent Blue Ⅴ in the intestinal loops: (1) Macroscopically healthy terminal ileum of patients with CD or colon cancer showed thin lymphatic vessels linearly directed toward the mesentery; (2) In mild lesions in which the intestinal wall did not reach 8 mm of thickness, we observed short, wide and tortuous lymphatic vessels directed longitudinally along the intestinal axis toward disease-free areas and then transversally toward the mesentery; and (3) Injection in the severely affected lesions, that had a thickness of the intestinal wall over 10 mm, did not show any feature of lymphatic vessels at least on the subserosal surface. There was a correlation between the thickness of the parietal wall and the severity of the lymphatic alterations. Normal lymphatic vessels were observed at previous strictureplasties in the presence of complete regression of the inflammation. CONCLUSION:Injection of Patent Blue Ⅴ in the intestinal wall could help distinguish healthy tracts of the small bowel from those macroscopically borderline.

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“…New types of strictureplasty also were used for long strictures (Studies 11, [19][20][21][22]. 31,[39][40][41][42] The side-to-side isoperistaltic strictureplasty was used for 5 percent (148/3,081 sites) of strictures. 31 The most common site of strictureplasty was jejunum and/or ileum (94 percent; 2,242/2,403 sites).…”

Section: Overall Experience Of Strictureplastymentioning

confidence: 99%