STRICTUREPLASTY FOR CROHNS-DISEASE IN JAPAN

Strictureplasty has recently been advocated in the treatment of obstru ctive strictures of the small bowel in patients with Crohn's disease. In this group study, results for 69 patients with Crohn's disease who underwent strictureplasty were analyzed by sending questionnaires to 1 3 institutions belonging to the Research Committee of Inflammatory Bow el Disease of the Japanese Ministry of Health and Welfare. No mortalit y and anastomotic leakage were observed. Strictureplasties of both the Heineke-Mikulicz and Finney varieties were considered to be safe proc edures, even though the sutures had to be applied at the slightly infl ammed site. The median follow up was 37 months (range, 0-133 months), and 12 patients needed reoperation. The cumulative 3-year operation-fr ee rate was 92.5% and the 5-year rate was 70.3%. The site of the lesio n, the strictureplasty procedure, and previous history of small bowel resection did not significantly influence the operation-free intervals . The cumulative 5-year operation-free rate of the group treated with home elemental enteral nutrition (83.3%) was better than that of the n on-treated group (65.3%). Strictureplasty was found to be a safe and e ffective surgical procedure for high-risk patients with Crohn's diseas e in whom an appropriate length of bowel should be saved.