Long-term results of strictureplasty for ileocolonic anastomotic recurrence in Crohn's disease

This study examined the outcome of strictureplasty for recurrence at the il eocolonic anastomosis after resection (ileocolonic strictureplasty) in Croh n's disease. The records of 42 patients who underwent ileocolonic stricture plasty between 1980 and 1997 were reviewed. The method of ileocolonic stric tureplasty was Heineke-Mikulicz reconstruction for a short stricture (less than or equal to 6 cm) in 41 patients and Finney reconstruction for a long stricture (20 cm) in one. Synchronous operations were performed for coexist ing small bowel Crohn's disease in 17 patients: strictureplasty in eight, r esection in two, and both in seven. Postoperatively there were two intra-ab dominal abscesses, which were treated conservatively There were no deaths. All except two patients had complete relief of symptoms after operation. Mo st of the patients who had preoperative weight loss gained a eight (median gain +2.6 kg). After a median follow-up of 99 months, 24 patients (57%) had a symptomatic recurrence. Three patients were successfully managed by medi cal treatment. The other 21 patients (50%) required surgery for recurrence (20 for recurrence at the previous ileocolonic strictureplasty site). At pr esent, two patients are symptomatic and currently receiving corticosteroid therapy. All other patients have had no recurrent symptoms. None of the pat ients have developed short bowel syndrome or small bowel carcinoma. Strictu replasty is a safe and efficacious procedure for ileocolonic anastomotic re currence in Crohn's disease.