J Serra1, Z Cohen, R S McLeod. 1. Division of General Surgery, Mount Sinai Hospital, Toronto, Ont.
Abstract
OBJECTIVE: To study the short- and long-term outcomes in patients with Crohn's disease who have undergone strictureplasty. DESIGN: A retrospective review with a prospective follow-up (mean 54.4 months [range from 4 to 108 months]). SETTING: The Inflammatory Bowel Disease Centre at Mount Sinai Hospital in Toronto. PATIENTS: Forty-three patients (29 men, 14 women) who underwent 154 strictureplasties for Crohn's disease. The mean age of the patients was 32.5 years (range from 17 to 55 years). INTERVENTION: Strictureplasty by either the Heineke-Mikulicz (145 strictureplasties) or the Finney (9 strictureplasties) technique in the duodenum, small intestine and at the site of the previous anastomosis. MAIN OUTCOME MEASURES: Factors studied for symptomatic recurrence included the type of procedure previously performed, the type of strictureplasty, the number of previous operations and the site of the disease. RESULTS: There were no deaths. There was one documented leak. Twenty-six patients remained symptom free during the follow-up period. Fourteen patients required reoperation for progressive obstructive disease. None of the differences in the variables studied was statistically significant when related to the symptomatic recurrence rate. However, only 2 of 11 patients who had strictureplasty as the only procedure have required reoperation. CONCLUSIONS: Strictureplasty is a safe and useful procedure in the management of extensive obstructive Crohn's disease. Strictureplasty does not seem to alter the natural history of the disease.
OBJECTIVE: To study the short- and long-term outcomes in patients with Crohn's disease who have undergone strictureplasty. DESIGN: A retrospective review with a prospective follow-up (mean 54.4 months [range from 4 to 108 months]). SETTING: The Inflammatory Bowel Disease Centre at Mount Sinai Hospital in Toronto. PATIENTS: Forty-three patients (29 men, 14 women) who underwent 154 strictureplasties for Crohn's disease. The mean age of the patients was 32.5 years (range from 17 to 55 years). INTERVENTION: Strictureplasty by either the Heineke-Mikulicz (145 strictureplasties) or the Finney (9 strictureplasties) technique in the duodenum, small intestine and at the site of the previous anastomosis. MAIN OUTCOME MEASURES: Factors studied for symptomatic recurrence included the type of procedure previously performed, the type of strictureplasty, the number of previous operations and the site of the disease. RESULTS: There were no deaths. There was one documented leak. Twenty-six patients remained symptom free during the follow-up period. Fourteen patients required reoperation for progressive obstructive disease. None of the differences in the variables studied was statistically significant when related to the symptomatic recurrence rate. However, only 2 of 11 patients who had strictureplasty as the only procedure have required reoperation. CONCLUSIONS: Strictureplasty is a safe and useful procedure in the management of extensive obstructive Crohn's disease. Strictureplasty does not seem to alter the natural history of the disease.
Authors: Calvin J Coffey; Miranda G Kiernan; Shaheel M Sahebally; Awad Jarrar; John P Burke; Patrick A Kiely; Bo Shen; David Waldron; Colin Peirce; Manus Moloney; Maeve Skelly; Paul Tibbitts; Hena Hidayat; Peter N Faul; Vourneen Healy; Peter D O'Leary; Leon G Walsh; Peter Dockery; Ronan P O'Connell; Sean T Martin; Fergus Shanahan; Claudio Fiocchi; Colum P Dunne Journal: J Crohns Colitis Date: 2018-11-09 Impact factor: 9.071