Strictureplasty and intestinal resection: different options in complicated pediatric-onset Crohn disease

Romeo, Erminia; Jasonni, Vincenzo; Caldaro, Tamara; Barabino, A.; Mattioli, Girolamo; Vignola, Stefania; Abriola, Giovanni Federici di; Angelis, Paola De; Pane, Alessandro; Torroni, Filippo; Rea, Francesca; Dall’Oglio, Luigi

doi:10.1016/j.jpedsurg.2012.01.054

Cited by 24 publications

(15 citation statements)

References 24 publications

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“…Stricturoplasty can be beneficial over bowel resection because it avoids a reduction in bowel length. Complication rates compared to surgical resection are generally low [7,8,26]. However, studies directly comparing stricturoplasty to bowel resection in paediatric patients have shown conflicting results.…”

Section: Stricturoplastymentioning

confidence: 99%

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Therapeutic strategies for stricturing Crohn’s disease in childhood: a systematic review

et al. 2021

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Purpose Childhood stricturing Crohn’s disease (CD) has significant morbidity. Interventions including resection, stricturoplasty and endoscopic balloon dilatation (EBD) are often required. Optimal intervention modality and timing, and use of adjuvant medical therapies, remains unclear. We aim to review the therapies used in paediatric stricturing CD. Methods A systematic review in accordance with PRISMA was performed (PROSPERO: CRD42020164464). Demographics, stricture features, interventions and outcomes were extracted. Results Fourteen studies were selected, including 177 patients (183 strictures). Strictures presented at 40.6 months (range 14–108) following CD diagnosis. Medical therapy was used in 142 patients for an average of 20.4 months (2–36), with a complete response in 11 (8%). Interventions were undertaken in 138 patients: 53 (38%) resections, 39 (28%) stricturoplasties, and 17 (12%) EBD. Complications occurred in 11% of resections, versus 15% stricturoplasties, versus 6% EBD (p = 0.223). At a median follow-up of 1.9 years (interquartile range 1.2–2.4) pooled stricture recurrence was 22%. Resection had 9% recurrence, versus 38% stricturoplasty, versus 47% EBD (p < 0.001). Conclusions Resection is associated with a low incidence of recurrence and complications. There remains a paucity of evidence regarding adjuvant medical therapy and the role of EBD. We propose a minimum reported dataset for interventions in paediatric stricturing CD.

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Section: Stricturoplastymentioning

confidence: 99%

“…Approximately 25% of children with CD will develop stricturing disease (B2) at some point [4]. Complicated CD often requires intervention, and estimated lifetime risk of surgery in this patient group is 50-90% [7,8].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic strategies for stricturing Crohn’s disease in childhood: a systematic review

et al. 2021

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“…Операцией выбора является илеоцекальная резекция с формированием илео-асцендоанастомоза [160,167]. Предпочтительной методикой формирования тонкокишечного ана-стомоза является наложение аппаратного анастомоза по типу «бок-в-бок», что уменьшает веро-ятность его несостоятельности и последующего развития стриктуры [168,169].…”

Section: хирургическое лечение бк тонкой кишки и илеоцекальной зоныunclassified

Draft recommendations of the russian society of pediatric gastroenterology, hepatology and nutrition on diagnosis and treatment of Crohn's disease in children

Корниенко

Хавкин

Федулова

et al. 2019

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The final version of the draft protocol for the diagnosis and treatment of Crohn’s disease in children, developed by experts of the Russian Society of Pediatric Gastroenterology, Hepatology and Nutrition, is presented in the article. This project has been repeatedly discussed by pediatric gastroenterologists - specialists in the study of IBD in children during round tables at the XXV-th and XXVI-th Congres of Pediatric Gastroenterologists of Russia and, after final approval, will be presented in the form of clinical recommendations.

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“…Results from a small study comparing stricturoplasty to intestinal resection in pediatric patients showed no significant difference in relapse rate or complications. 64 The technique entails a longitudinal enterotomy through the strictured segment with closure in a transverse fashion to relieve the obstruction (Heineke-Mikulicz stricturoplasty). The results following this operation are quite good even when applied to multiple strictures in the same patient.…”

Section: Stricturoplastymentioning

confidence: 99%

Pediatric Crohn's Disease

Allmen

2018

Clinics in Colon and Rectal Surgery

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The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatment. The majority of children are diagnosed in the early teen years, but subgroups of very early onset and infantile Crohn's present much earlier and have a unique clinical course. Treatment paradigms follow the traditional laddered approach, but growth and development represent special considerations that must be given to pediatric-specific complications of the treatment and disease. Surgical intervention is an important component of Crohn's management and is often employed to allow improved nutritional intake or decrease reliance on medical treatments that compromise growth.

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Strictureplasty and intestinal resection: different options in complicated pediatric-onset Crohn disease

Cited by 24 publications

References 24 publications

Therapeutic strategies for stricturing Crohn’s disease in childhood: a systematic review

Therapeutic strategies for stricturing Crohn’s disease in childhood: a systematic review

Draft recommendations of the russian society of pediatric gastroenterology, hepatology and nutrition on diagnosis and treatment of Crohn's disease in children

Pediatric Crohn's Disease

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