STRICTUREPLASTY FOR CROHNS-DISEASE - TECHNIQUES AND LONG-TERM RESULTS

Strictureplasty for treatment of symptomatic intestinal strictures sec ondary to Crohn's disease is being performed with increasing frequency . To determine the overall clinical results after strictureplasty for Crohn's disease, all patients undergoing this procedure were prospecti vely studied. Between 6/1/89 and 2/1/97, 57 Crohn's disease patients u nderwent 60 operations utilizing strictureplasties. A total of 109 str ictureplasties were performed (90 Heineke-Mikulicz, 6 Finney, and 13 s ide-to-side isoperistaltic). The 30-day perioperative morbidity was 12 %, with complications being less common for patients undergoing electi ve versus unscheduled operations (p < 0.002). Recurrence of Crohn's di sease requiring operation was seen in seven patients after a mean foll ow-up of 38 months. The estimated cumulative recurrence rate after 2 y ears was 15 +/- 6% (+/- standard error) and 22 +/- 10% at 5 years. A r ecurrence developed at the site of the previous strictureplasty in onl y five cases. Strictureplasty is a safe, effective means of providing long-term surgical palliation to selected patients with Crohn's diseas e. Perioperative complication rates are comparable to those seen with standard surgical treatment, and recurrences are not excessive.