Ten-year experience of strictureplasty for obstructive Crohn's disease

Abstract

Strictureplasty is controversial in the management of obstructive Crohn's disease. Only a small proportion of patients undergoing surgery for obstructive Crohn's disease are suitable for strictureplasty. Lesions which are most amenable for this procedure are short, fibrous strictures. Over a 10-year period 24 patients have undergone 30 operations at which 86 strictureplasties were performed. The median follow-up has been 40 (range 4-112) months. No leaks or fistulae arose from the strictureplasties. The median weight gain 3 months postoperatively was +4.0 kg. Four patients subsequently required a further 13 strictureplasty procedures, between 12 and 36 (median 18) months after the initial operation; all but one of the previous strictureplasties were patent. Thirteen patients have been symptom free following surgery, four have required further medical therapy for recurrent Crohn's disease and three have sustained episodes of self-limiting intestinal colic. Strictureplasty is a safe and effective procedure in selected patients undergoing surgery for obstructive Crohn's disease.

Endoscopic balloon dilatation of duodenal strictures in Crohn’s disease

“…This includes the performance of limited resections and stricturoplasty where possible. 3 The main indication for surgery in Crohn's disease is that of fibrous strictures resulting in obstruction. Strictures elsewhere Treatment options for strictures in Crohn's disease * resection of stricture * stricturoplasty * endoscopic balloon dilatation Box 1 in the gastrointestinal tract can be treated endoscopically with balloon dilatation.…”

Crohn's disease: indications for and results of strictureplasty

“…So far, the reported rate of septic complications related to leakage after strictureplasty reaches 8%, with a reoperation rate of 5% [20]. This rate is not different from the incidence of septic complications observed for resective surgical procedures [21].…”

Pseudotumoral appearance of small bowel strictureplasty for Crohn's disease

“…Strictureplasty is now a common procedure for the relief of obstructive Crohn's disese [4]. The practice of marking strictureplasties with a surgical clip (Fig.…”