Mayo Clin Proc  1994 Jan;69(1):33-6 

Strictureplasty for obstructive Crohn's disease: the Mayo experience.

Spencer MP, Nelson H, Wolff BG, Dozois RR.

Department of Surgery, Mayo Clinic, Rochester, MN 55905.

BACKGROUND: Strictureplasty for obstructive Crohn's disease of the small bowel

continues to gain favor throughout the world. Although the potential advantages

of preserving intestinal length are obvious, the optimal clinical setting for

performing strictureplasty remains to be determined. PATIENTS: Of 244 patients

who underwent abdominal exploration for complications of Crohn's disease between

Jan. 1, 1985, and Jan. 1, 1991, at the Mayo Clinic, 35 had a total of 71

strictureplasties. Concomitant resection of bowel with active disease was

performed in 67% of the procedures. RESULTS: In this series, no perioperative

deaths occurred, and no anastomotic leaks, enteric fistulas, or intra-abdominal

abscesses were noted during a 3-year follow-up. The overall perioperative

complication rate was 14%. Postoperatively, 33 of the 35 patients were able to

resume enteral nutrition and discontinue medical treatments. The symptomatic

recurrence rate at 3 years was 20%; six patients have required reoperation.

CONCLUSION: These findings support the use of strictureplasty for isolated,

quiescent, stenotic bowel lesions associated with Crohn's disease.