Strictureplasty for large bowel stenosis in Crohn's disease: quality of life after surgical therapy

The aim of surgical therapy in Crohn's disease is to improve quality of lif e. Surgery does not provide cure with radical resection of inflamed bowel. Therefore stricture-plasty has become a useful bowel-preserving surgical te chnique in the treatment of small-bowel stenosis. To preserve functional bo wel we extended the indication of this surgical technique to strictures in large bowel. The aim of this retrospective study was to define the efficacy of strictureplasty and resection in patients with obstructive Crohn's dise ase of the colon. The results were evaluated in terms of postoperative comp lications, surgical recurrence, and quality of life. The charts of 58 patie nts with Crohn's colitis were analyzed retrospectively. Patients were eithe r treated by strictureplasty or resection. Quality of life was evaluated in follow-up examinations using the Inflammatory Bowel Disease Questionnaire. The incidence of postoperative surgical recurrence was 36% in those treate d by strictureplasty and 24% in those treated by resection (ns). Postoperat ive morbidity was 16.1% in the former and 22.3% in the latter. There was no significant difference between the groups in quality of life measures (177 versus 182 points). Strictureplasty in Crohn's colitis is a valuable surgi cal technique which results in low recurrence rates and in surgical outcome comparable to that in resection without sacrificing functional large bowel length. In our study quality of life after strictureplasty was comparable with quality of life after resection.