Strictureplasty. A good operation for small bowel Crohn's disease?

Seven patients with widespread, active, stricturing, small intestinal Crohn's disease and two with localized disease were treated by a total of 45 strictureplasties. They have been followed up for a mean of 20 months (range 6 to 30). Two patients had early postoperative complications with enterocutaneous fistulas, one of which may have been related to a strictureplasty. The two patients with localized disease remain well after 16 and 30 months. Of the seven patients with extensive small bowel disease, two are well six and 28 months after surgery. Recurrent symptoms developed in six patients two to six months postoperatively; four of those patients required further surgery. Previous reports of strictureplasty in inactive Crohn's strictures suggest it is a safe operation with good long-term results. Strictureplasty in active Crohn's disease has a much higher recurrence rate of symptoms. Because it is a conservative operation, however, we believe it has a place in the surgical treatment of Crohn's disease.