Abstract
We report an audit of outcome on 24 patients (16 females) who had a strictureplasty to treat ileo-colic anastomotic strictures. All except one patient had their original resection for Crohn's disease, and required reoperation because of symptoms of recurrent intestinal obstruction for a mean 9.3 months (range 1–36); the remaining patient was discovered to have ileo-colic anastomotic stricture before he underwent laparotomy for closure of loop ileostomy. At operation, four patients needed additional small bowel strictureplasties, two of whom also underwent small bowel resection for separate areas of phlegmonous disease. There was no post-operative mortality, three patients developed wound infection and one had a pelvic abscess, which settled on antibiotic therapy. Two patients have since died of unrelated disease. Five patients have since needed reoperation for recurrence; only one had a stricture at the site of previous strictureplasty. Over a mean follow-up of 70.8 months (range 18–393) all 22 living patients now have complete relief of symptoms.
Résumé
Nous rapportons une étude sur les résultats de 24 malades (16 femmes) qui ont eu une stricturoplastie comme traitement d'une sténose d'anastomose iléo-colique. Tous les malades à l'exception d'un avaient eu une résection première pour maladie de crohn et nécessitaient une réintervention en raison de symptomes d'obstructions récidivantes intestinales durant en moyenne depuis 9.3 mois (1–36 mois); chez le dernier malade une sténose anastomotique iléo-colique a été découverte avant une laparotomie pour fermeture de son iléostomie. Durant l'intervention 4 patients ont nécessité des stricturoplasties additionnelles au niveau de l'intestin grèle, deux d'entre eux subirent aussi une résection du grèle pour des zones séparées de maladie phlegmoneuse. Il n'y a pas eu de mortalité opératoire. Trois patients ont développé une infection pariétale et un a fait un abcés pelvien qui a guéri par antibiothérapie. Deux patients sont depuis morts d'une affection sans relation avec la maladie de Crohn. Cinq malades ont depuis nécessité une nouvelle réintervention pour récidive. Un seulement avait une sténose au niveau d'un site précédent de stricturoplastie. Avec un recul moyen de 70.8 mois (18–393 mois) les 22 patients vivants ont une disparition complète de leurs symptomes.
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Sharif, H., Alexander-Williams, J. Strictureplasty for ileo-colic anastomotic strictures in Crohn's disease. Int J Colorect Dis 6, 214–216 (1991). https://doi.org/10.1007/BF00341394
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DOI: https://doi.org/10.1007/BF00341394