Long strictureplasty is as safe and effective as short strictureplasty in small-bowel Crohn's disease

Background  For the past 20 years it has been shown that intestinal strictureplasty is safe and effective in the management of short strictureplasty. Long strictureplasty (> 20 cm) may be an alternative to resection in some patients, especially in diffuse disease or after previous extensive resec...

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Bibliographic Details
Published in:Colorectal disease 2004-11, Vol.6 (6), p.438-441
Main Authors: Shatari, T., Clark, M. A., Yamamoto, T., Menon, A., Keh, C., Alexander-Williams, J., Keighley, M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Child
Cohort Studies
Crohn Disease - complications
Crohn Disease - surgery
Crohn's Disease
Digestive System Surgical Procedures - methods
Female
Follow-Up Studies
Humans
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Intestine, Small - pathology
Intestine, Small - surgery
Laparotomy - methods
Long strictureplasty
Male
Middle Aged
Minimally Invasive Surgical Procedures - methods
Probability
Recurrence
Reoperation - statistics & numerical data
Retrospective Studies
Risk Assessment
Severity of Illness Index
small intestine
Statistics, Nonparametric
Time Factors
Treatment Outcome
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Summary:Background  For the past 20 years it has been shown that intestinal strictureplasty is safe and effective in the management of short strictureplasty. Long strictureplasty (> 20 cm) may be an alternative to resection in some patients, especially in diffuse disease or after previous extensive resections. We reviewed the outcome of long strictureplasty for Crohn's Disease, to examine safety and recurrence rates, compared with conventional short strictureplasty. Methods  Sixty‐two patients have undergone single strictureplasty for jejunoileal Crohn's disease since 1974. Median follow‐up was 121 (range 7–253) months. Twenty‐one operations involved a single long strictureplasty, and 41 operations had a single short strictureplasty. Results  No significant differences were identified between the groups. The postoperative complications in long strictureplasty included 2 abscesses only and after short strictureplasty there was one anastomotic leak and one postoperative abscess. The median hospital stay was 10 days after long strictureplasty and 9 days after short strictureplasty. Three‐, 5‐ and 10‐year disease‐free rates for long and short strictureplasty, respectively, were 3‐year 80.4% and 62.1%; 5‐year 55.2% and 49.8% and 10‐year 49.1% and 33.5% (NS). Conclusions  These data indicate that long strictureplasty is safe and produces equivalent results to conventional (short) strictureplasty.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2004.00664.x