DESCRIPTION OF NEW BOWEL SPARING TECHNIQUES FOR LONG STRICTURES OF CROHNS-DISEASE

In the period of January 1993 to December 1995 we operated on 55 patie nts with various complications of Crohn's disease. In properly selecte d cases, obstructive complications of Crohn's disease can be treated e ffectively by strictureplasty, Long strictures, even if a narrow lumen is still present, are commonly managed by resection, as classic stric tureplasties cannot be done; also Finney strictureplasty seems inadequ ate, as it creates a blind loop that favors bacterial overgrowth and f ecal stasis, Three original ''sparing bowel'' surgical approaches are proposed as possible alternative in the treatment of long stricture in Crohn's disease, We perform side-to-side ileoileal plasty whenever we are faced with severe narrowing of a long segment of small bowel (>10 cm); side-to-side ileocolic plasty whenever very severe disease with narrowing of ileocaecal valve is present; and ileocaecal plasty when t erminal ileitis involves the very distal end of the small bowel, but s paring or only minimally affecting the ileocaecal valve, The above-men tioned procedures are described in detail and the clinical outcomes re lated to the first 8-patient series of our institution are presented. (C) 1997 by Excerpta Medica, Inc.