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Ileocecal strictureplasty for Crohn's disease: long-term results and comparison with ileocecal resection.
- Source :
-
World journal of surgery [World J Surg] 2010 Dec; Vol. 34 (12), pp. 2860-6. - Publication Year :
- 2010
-
Abstract
- Background: The aim of the present study was to evaluate strictureplasty as the first choice for surgical treatment for Crohn's terminal ileitis.<br />Methods: Between 1996 and 2000 we performed Finney-shaped ileocecal strictureplasty (ICS), doubling up the diseased terminal ileum, in 14 patients affected by Crohn's disease (group A). We compared the postoperative and long-term outcomes of these patients with those of 14 similar patients who underwent ileocecal resection with ileocolonic anastomosis during the same period (group B).<br />Results: No postoperative morbidity or mortality was recorded in group A, whereas two patients of group B had a pelvic hematoma and cholestatic hepatopathy, respectively. The mean hospital stay after surgery was 9.9 days (range 7-13 days) in group A and 7.4 days (range 6-10 days) in group B. After a median follow-up of 120 months (range 103-147 months), five patients of group A had a symptomatic recurrence: A stricture at the site of the ICS was present in four of them, but only one required surgery; symptoms were controlled by medical therapy in the other three. The fifth symptomatic patient was reoperated for multiple jejunoileal recurrence of the disease above the ICS. Group B patients have been followed for a mean of 108 months (range 90-140 months). Four of the patients had a preanastomotic recurrence, with subocclusive symptoms and mild malnutrition treated with medical therapy.<br />Conclusions: Our results indicate that there are no significant differences between ICS and resection in terms of outcome and clinical relapse of Crohn's terminal ileitis.
Details
- Language :
- English
- ISSN :
- 1432-2323
- Volume :
- 34
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- World journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 20625729
- Full Text :
- https://doi.org/10.1007/s00268-010-0708-9