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  • Title: Natural history of strictureplasty in Crohn's disease: 9-year experience.
    Author: Serra J, Cohen Z, McLeod RS.
    Journal: Can J Surg; 1995 Dec; 38(6):481-5. PubMed ID: 7497360.
    Abstract:
    OBJECTIVE: To study the short- and long-term outcomes in patients with Crohn's disease who have undergone strictureplasty. DESIGN: A retrospective review with a prospective follow-up (mean 54.4 months [range from 4 to 108 months]). SETTING: The Inflammatory Bowel Disease Centre at Mount Sinai Hospital in Toronto. PATIENTS: Forty-three patients (29 men, 14 women) who underwent 154 strictureplasties for Crohn's disease. The mean age of the patients was 32.5 years (range from 17 to 55 years). INTERVENTION: Strictureplasty by either the Heineke-Mikulicz (145 strictureplasties) or the Finney (9 strictureplasties) technique in the duodenum, small intestine and at the site of the previous anastomosis. MAIN OUTCOME MEASURES: Factors studied for symptomatic recurrence included the type of procedure previously performed, the type of strictureplasty, the number of previous operations and the site of the disease. RESULTS: There were no deaths. There was one documented leak. Twenty-six patients remained symptom free during the follow-up period. Fourteen patients required reoperation for progressive obstructive disease. None of the differences in the variables studied was statistically significant when related to the symptomatic recurrence rate. However, only 2 of 11 patients who had strictureplasty as the only procedure have required reoperation. CONCLUSIONS: Strictureplasty is a safe and useful procedure in the management of extensive obstructive Crohn's disease. Strictureplasty does not seem to alter the natural history of the disease.
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