Strictureplasty in Crohn's disease - Surgical option

PURPOSE: The objective of this study Ras to review early and late results o f our personal experience with strictureplasty for patients affected by Cro hn's disease. METHOD: During a 16-year period, 44 of 383 patients underwent strictureplasty. Of the 269 strictures present at surgery, 174 were treate d by performing strictureplasties (156 were closed transversely according t o the Heineke-Mikulicz technique, 16 were done side-to-side in the Finney m anner, and 2 were done according to Jaboulay technique), and 88 were treate d with a synchronous resection. An individualized technique was used for se ven other strictures, with side-to-side ileocolic (5 strictures in 3 patien ts) or ileoileal anastomosis (2 strictures in one patient). RESULTS: No ope rative mortality was recorded, nor were septic complications caused by anas tomotic leakage observed. The mean follow-up period was 47.8 +/- 42.4 (rang e, 3-132) months. After a median follow-up period of 50 (range, 18-89) mont hs, a second operation for symptomatic recurrence was performed on ten pati ents, and two of them developed new symptomatic strictures after 3 and 36 m onths, requiring a third operation. Symptomatic restrictures of previous st rictureplasty sites requiring surgery occurred in 8.8 percent of cases. Fur thermore, no statistically significant difference (Kaplan-Meier) was observ ed in the reoperation rate among the patients with skip lesions or closed s trictures or among patients treated by strictureplasty alone or with associ ated resection. CONCLUSION:: We conclude that strictureplasty is a valuable adjunct or alternative to resection in the treatment of Crohn's strictures .