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A Journal on Surgery

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Minerva Chirurgica 2000 May;55(5):313-8

language: Italian

Strictureplasty in Crohn's disease. Indications and results

Resegotti A., Astegiano M., Sostegni R., Garino M., Fusi D., Longhin R.


Background. Aim of the paper is to evaluate the indications and results of strictureplasty in the treatment of intestinal obstruction due to Crohn's disease. It is hypothesized that, as far as fibrotic strictures are treated, operative morbidity will be reduced to a minimum.
Methods. Data regarding 147 interventions for Crohn's disease performed in a 4.5 year-period have been prospectively collected. Eight interventions including strictureplasty have been identified and indication, morbidity and end results analyzed.
Results. In 8 interventions 20 strictureplasties have been performed. As a rule, a strictureplasty is performed only when a resection would have sacrificed a too long bowel tract or it was anappropriate, in relation to stricture site. Three patients had fistulae, but those fistulae were not in the same site of strictureplasty and only one patient was malnourished and with active disease. There was no operative mortality or major morbidity, but there was only a short episode of hyperthermia. No relapses were observed after a 26-month mean follow-up.
Conclusions. Strictureplasty is a useful tool in order to avoid extensive intestinal resections. If it is performed only on fibrotic strictures with inactive disease and only if a resection is deemed inappropriate, minimal morbidity and very good results can be anticipated.

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