Am J Surg  1997 Jun;173(6):509-12 

Description of new "bowel-sparing" techniques for long strictures of Crohn's

disease.

Taschieri AM, Cristaldi M, Elli M, Danelli PG, Molteni B, Rovati M, Porro GB.

State University of Milan, Division of General Surgery, Italy.

In the period of January 1993 to December 1995 we operated on 55 patients with

various complications of Crohn's disease. In properly selected cases,

obstructive complications of Crohn's disease can be treated effectively by

strictureplasty. Long strictures, even if a narrow lumen is still present, are

commonly managed by resection, as classic strictureplasties cannot be done; also

Finney strictureplasty seems inadequate, as it creates a blind loop that favors

bacterial overgrowth and fecal stasis. Three original "sparing bowel" surgical

approaches are proposed as possible alternative in the treatment of long

stricture in Crohn's disease. We perform side-to-side ileoileal plasty whenever

we are faced with severe narrowing of a long segment of small bowel (>10 cm);

side-to-side ileocolic plasty whenever very severe disease with narrowing of

ileocaecal valve is present; and ileocaecal plasty when terminal ileitis

involves the very distal end of the small bowel, but sparing or only minimally

affecting the ileocaecal valve. The above-mentioned procedures are described in

detail and the clinical outcomes related to the first 8-patient series of our

institution are presented.