How safe is strictureplasty in the management of Crohnʹs disease?

Background Strictureplasty is a well-accepted technique in the management of selected patients with Crohnʹs disease. To determine the safety and optimal clinical setting for performing Strictureplasty, perioperative complications and long-term outcomes need to be analyzed. Patients and materials We retrospectively reviewed the charts of 162 patients (87 men, 75 women) with Crohnʹs disease who underwent Strictureplasty between June 1984 and July 1994. Medical and surgical history, including medications and laboratory data, intraoperative findings, perioperative complications, and long-term follow-up data were recorded. Results These patients underwent 698 strictureplasties (Heineke-Mikulicz procedures, 617; Finney procedures, 81). Median hospital stay was 8 days. Perioperative septic complications were noted in 8 patients (5%); however, reoperation for sepsis was needed only in 5 patients. Five percent of patients developed prolonged ileus after Strictureplasty. Symptomatic improvement after Strictureplasty was achieved in 98% of patients. Restricture or new stricture or perforative disease was seen in 5% and 17% of patients, respectively, during a 42-month median follow-up period. Conclusions Our findings show that Strictureplasty is a good surgical option for stenosing small-bowel Crohnʹs disease, particularly in patients with multiple obstruction and in those vulnerable to short-bowel syndrome. Perioperative complications are few, and long-term results are gratifying.