T Yamamoto1, M R Keighley. 1. University Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom.
Abstract
BACKGROUND: This retrospective study was undertaken to examine the long-term outcome of strictureplasty for Crohn's disease and factors affecting the incidence of postoperative septic complications and recurrence. METHODS: Eighty-seven patients who underwent 245 primary jejunoileal strictureplasties for jejunoileal Crohn's disease between 1980 and 1997 were reviewed. RESULTS: Septic complications (fistula/abscess) occurred in 7 patients (all at strictureplasty site). Only intra-abdominal sepsis with peritoneal contamination at laparotomy was significantly associated with these complications. After a median follow-up of 104 months, 49 patients (56%) developed symptomatic recurrence. In 11 patients, symptomatic recurrence was successfully managed by medical treatment. Thirty-eight patients (44%) required further surgery for recurrence. Only young age (< or = 37 years) was associated with high incidence of reoperation for recurrence. Preoperative steroid use, nutritional status, synchronous bowel resection, and number, site, or length of strictureplasties did not affect the incidence of septic complications and recurrence requiring reoperation. CONCLUSIONS: Intra-abdominal sepsis with peritoneal contamination increased the incidence of septic complications. Only young age was associated with the increased risk of recurrence requiring reoperation.
BACKGROUND: This retrospective study was undertaken to examine the long-term outcome of strictureplasty for Crohn's disease and factors affecting the incidence of postoperative septic complications and recurrence. METHODS: Eighty-seven patients who underwent 245 primary jejunoileal strictureplasties for jejunoileal Crohn's disease between 1980 and 1997 were reviewed. RESULTS:Septic complications (fistula/abscess) occurred in 7 patients (all at strictureplasty site). Only intra-abdominal sepsis with peritoneal contamination at laparotomy was significantly associated with these complications. After a median follow-up of 104 months, 49 patients (56%) developed symptomatic recurrence. In 11 patients, symptomatic recurrence was successfully managed by medical treatment. Thirty-eight patients (44%) required further surgery for recurrence. Only young age (< or = 37 years) was associated with high incidence of reoperation for recurrence. Preoperative steroid use, nutritional status, synchronous bowel resection, and number, site, or length of strictureplasties did not affect the incidence of septic complications and recurrence requiring reoperation. CONCLUSIONS:Intra-abdominal sepsis with peritoneal contamination increased the incidence of septic complications. Only young age was associated with the increased risk of recurrence requiring reoperation.
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