HOW SAFE IS STRICTUREPLASTY IN THE MANAGEMENT OF CROHNS-DISEASE

BACKGROUND: Strictureplasty is a well-accepted technique in the manage ment of selected patients with Crohn's disease, To determine the safet y and optimal clinical setting for performing strictureplasty, periope rative complications and long-term outcomes need to be analyzed. PATIE NTS AND MATERIALS: We retrospectively reviewed the charts of 162 patie nts (87 men, 75 women) with Crohn's disease who underwent stricturepla sty between June 1984 and July 1994, Medical and surgical history, inc luding medications and laboratory data, intraoperative findings, perio perative complications, and longterm follow-up data were recorded. RES ULTS: These patients underwent 698 strictureplasties (Heineke-Mlkulicz procedures, 617; Finney procedures, 81), Median hospital stay was 8 d ays, Perioperative septic complications were noted in 8 patients (5%); however, reoperation for sepsis was needed only in 5 patients. Five p ercent of patients developed prolonged ileus after strictureplasty, Sy mptomatic improvement after strictureplasty was achieved in 98% of pat ients, Restricture or new stricture or perforative disease was seen in 5% and 17% of patients, respectively, during a 42-month median follow -up period. CONCLUSIONS: Our findings show that strictureplasty is a g ood surgical option for stenosing small-bowel Crohn's disease, particu larly in patients with multiple obstruction and in those vulnerable to short-bowel syndrome. Perioperative complications are few, and long-t erm results are gratifying.