STRICTUREPLASTY FOR OBSTRUCTIVE CROHNS-DISEASE - THE MAYO EXPERIENCE

Background: Strictureplasty for obstructive Crohn's disease of the sma ll bowel continues to gain favor throughout the world. Although the po tential advantages of preserving intestinal length are obvious, the op timal clinical setting for performing strictureplasty remains to be de termined. Patients: Of 244 patients who underwent abdominal exploratio n for complications of Crohn's disease between Jan. 1, 1985, and Jan. 1, 1991, at the Mayo Clinic, 35 had a total of 71 strictureplasties. C oncomitant resection of bowel with active disease was performed in 67% of the procedures. Results: In this series, no perioperative deaths o ccurred, and no anastomotic leaks,enteric fistulas, or intra-abdominal abscesses were noted during a 3-year follow-up. The overall periopera tive complication rate was 14%. Postoperatively, 33 of the 35 patients were able to resume enteral nutrition and discontinue medical treatme nts. The symptomatic recurrence rate at 3 years was 20%; six patients have required reoperation. Conclusion: These findings support the use of strictureplasty for isolated, quiescent, stenotic bowel lesions ass ociated with Crohn's disease.