Results of surgical treatment for jejunal Crohn’s disease: choice between resection, strictureplasty, and combined treatment

Abstract

The most frequently employed surgery for the treatment of jejunal CD is a combined type of treatment, i.e., resection of the most affected tract and strictureplasty of the residual strictures. This approach does not imply an increased risk of postoperative complications and recurrence and can reduce the risk of the short bowel syndrome.

Short‐ and long‐term outcomes of strictureplasty for obstructive Crohn’s disease

“…Patients operated on with simultaneous resection and strictureplasty had the worst reoperation rate for new strictures compared with either strictureplasty or resection in isolation. This finding differs from earlier studies from units including our own in which there were no differences between strictureplasty alone or when combined with resection [18,21,23,24,27]. Although it differs from previous studies, we find it plausible that patients with both strictureplasty and resection have the worst outcome.…”

“…It has been concluded in several previous studies that strictureplasty is a relatively safe operation . Our results confirm this also to be true in the era of biologicals, with no postoperative mortality and only one patient requiring re‐laparotomy for a leak after strictureplasty.…”

“…Our results confirm this also to be true in the era of biologicals, with no postoperative mortality and only one patient requiring re‐laparotomy for a leak after strictureplasty. No statistically significant differences in morbidity were observed between the various procedures, in accordance with the findings of Tonelli et al . In the longer‐term, there are concerns that leaving inflamed bowel in situ after strictureplasty would lead to the eventual development of cancer, which has been reported in a small number of patients .…”