Strictureplasty vs resection in small bowel Crohn's disease: an evaluation of short‐term outcomes and recurrence

Abstract

Patients with small bowel CD undergoing strictureplasty alone may have fewer postoperative complications than those undergoing a concomitant bowel resection. However, surgical recurrence maybe higher following strictureplasty alone than with a concomitant small bowel resection. Patients may require appropriate preoperative counselling regarding the pros and cons of each operative technique.

Guidelines for the management of Crohn’s disease. Recommendations of the Working Group of the Polish National Consultant in Gastroenterology and the Polish Society of Gastroenterology

“…Warunkiem bezpiecznego poszerzenia endoskopowego jest brak owrzodzeń oraz krótki odcinek zwężenia (do 4 cm). Alternatywną metodą jest chirurgiczna plastyka zwężeń [101,102] (zwłaszcza u chorych zagrożonych zespołem krótkiego jelita, ze zwężeniami krótszymi niż 10 cm), a w przypadku długiego odcinka lub zwężeń wielopoziomowych oraz aktywnych zmian w zwężeniu -resekcja odcinkowa jelita [103]. Chirurgiczna plastyka zwężeń w jelicie grubym oraz wytworzenie zbiornika J-pouch nie są zalecane osób z ChLC.…”

Multidisciplinary Management of Gastrointestinal Fibrotic Stenosis in Crohn’s Disease

“…Stricturoplasty has also been associated with a risk of stricture relapse in 30-35 % of patients at 4-8 years [138,139]. Stricturoplasty is a safe alternative to resection in jejuno-ileal CD, including ileocolonic recurrence, with similar short-term and long-term results [140][141][142]. Reese et al [140] in their study revealed that there was an observed benefit of stricturoplasty over resection with regard to the overall early complications (17/134, 12.7 % in the stricturoplasty group and 36/188, 19.1 % in the resection group), but the difference was not statistically significant (p = 0.09).…”

Difference in Recurrence Patterns Between Anastomosis and Strictureplasty After Surgical Treatment for Crohn Disease

“…No significant difference is also reported in the recurrence rate after strictureplasty alone and strictureplasty plus resection. 16,20 However, metaanalysis of 7 studies performed by Reese et al 21 showed that patients who underwent resection had significantly longer recurrence-free survival than did those who underwent strictureplasty alone. In the present study, duration between previous operation and recurrence was significantly shorter in patients who underwent strictureplasty than in patients who underwent resection and anastomosis.…”

“…Controversy exists on the recurrence rate after strictureplasty and resection. 16,[18][19][20][21][22][23] Several invesigators 18,19 have reported no significant differences in rates of recurrence after strictureplasty versus resection. No significant difference is also reported in the recurrence rate after strictureplasty alone and strictureplasty plus resection.…”