Strictureplasty: An alternative approach in long segment bowel stenosis Crohn's disease

Background/Purpose: Intestinal resection is the most frequent surgical procedure for bowel stenoses in Crohn's disease (CD). Recurrence of strictures, particularly with ileocolonic disease, often requires resection of lengthy segments of bowel, potentially resulting in short bowel syndrome. Dif...

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Bibliographic Details
Published in:Journal of pediatric surgery 2003-05, Vol.38 (5), p.814-818
Main Authors: di Abriola, G.Federici, De Angelis, P., Dall'Oglio, L., Di Lorenzo, M.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
bowel stenoses
Colon - surgery
Colonic Diseases - etiology
Colonic Diseases - surgery
Crohn Disease - complications
Crohn Disease - surgery
Crohn's disease
Digestive System Surgical Procedures - methods
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Ileal Diseases - etiology
Ileal Diseases - surgery
Ileum - diagnostic imaging
Ileum - surgery
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Male
Medical sciences
Other diseases. Semiology
Radiography
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
stricture
strictureplasty
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Summary:Background/Purpose: Intestinal resection is the most frequent surgical procedure for bowel stenoses in Crohn's disease (CD). Recurrence of strictures, particularly with ileocolonic disease, often requires resection of lengthy segments of bowel, potentially resulting in short bowel syndrome. Different techniques of strictureplasty, such as those described by Mikulicz, Finney and Michelassi, are used in adults. However, these procedures are uncommon in pediatric surgery. The authors report their experience with different techniques of strictureplasty and with their modified Michelassi technique for the surgical treatment of long intestinal strictures caused by CD. Methods: Five adolescents (2 boys; 3 girls; mean age, 16 age; range, 14 to 20 years) with severe ileocolonic stenoses and intestinal obstruction, not responsive to medical and nutritional therapy, were treated with different strictureplasty techniques. In 3 of them the modified side-to-side Michelassi technique was used. Results: No postoperative complications occurred. After a mean follow-up of 20.5 months (range, 6 to 28 months), patients are free of symptoms with good nutritional status and off steroid therapy. Conclusions: Strictureplasty is a good and effective surgical option for sparing bowel length in CD patients with extensive intestinal strictures. J Pediatr Surg 38:814-818. © 2003 Elsevier Inc. All rights reserved.
ISSN:0022-3468
1531-5037
DOI:10.1016/jpsu.2003.50173