LONG-TERM FOLLOW-UP OF STRICTUREPLASTY IN CROHNS-DISEASE

Strictureplasty is an alternative to extensive and/or multiple small b owel resections in the surgical treatment of Crohn's disease. We here report a series of 22 patients (12 M - 10 F - mean age years 28). All patients had non perforative form of Crohn's disease lasting for a mea n of 8 years. Nine our of 22 had previous intestinal resections. A tot al of 201 stenosis was identified during per-operative examination (me an per patient: 9). Only tight stenoses (diameter < 2 cm) were treated while others were left untouched. Eighty-three stenoses were treated by short strictureplasty and 24 by long strictureplasty using steel th read. One or several resections were simultaneous performed in 15 pati ents. Mortality was nil. A post operative abcess without loosened sutu re was drained. The mean follow-up in the 22 patients was 36 months (r ange: 12 to 96). Relief of obstructive symptoms was achieved in all pa tients. Symptomatic recurrence occured in 9 patients (40%) and 5 (22%) needed reoperation. In one case haemorragic ulceration developed with in a long strictureplasty and in 4 others stenosis developed in plasty areas but also in previous healthy areas. Thus stricture-plasty is in tended not to replace resection but rather to serve as a useful adjunc t to the existing surgical options in the treatment of Crohn's disease , especially when short bowel syndrome is a consideration.