ENLARGEMENT ENTEROPLASTY FOR OBSTRUCTIVE CROHNS-DISEASE - THE UNIVERSITY-OF-MONTREAL EXPERIENCE

Multiple small bowel resections for obstructive symptoms caused by Cro hn's disease can lead to a short bowel and malabsorption. Preservation of intestinal length is possible by the use of strictureplasty. Betwe en August 1983 and March 1993, ninety strictureplasties were performed in 25 patients. They were 13 males and 12 females with a mean age of 37 years. Fourteen (56%) previously had small bowel resection for Croh n's disease. A mean number of 4.3 strictureplasties per patient were p erformed. Concomitant resection of bowel with active disease was perfo rmed in 18 patients (72%), In this series, no perioperative death occu rred and one patient developed an enterocutaneous fistula. The overall complication rate was 8%, Postoperatively, 18 patients (72%) were com pletely relieved of symptoms, 6 were improved (24%) and one became wor st (4%). After a 27 month follow-up period, the symptoms recurred in 1 3 patients (52%); three had no treatment, 7 had medical treatment and 3 required reoperation (12%). Our results support the safety and the u se of strictureplasty for stenotic bowel lesions associated with Crohn 's disease.