Serra J, Cohen Z, McLeod R S
Division of General Surgery, Mount Sinai Hospital, Toronto, Ont.
Can J Surg. 1995 Dec;38(6):481-5.
To study the short- and long-term outcomes in patients with Crohn's disease who have undergone strictureplasty.
A retrospective review with a prospective follow-up (mean 54.4 months [range from 4 to 108 months]).
The Inflammatory Bowel Disease Centre at Mount Sinai Hospital in Toronto.
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).
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.
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.
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.
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.
研究接受狭窄成形术的克罗恩病患者的短期和长期预后。
一项回顾性研究，并进行前瞻性随访（平均54.4个月[范围为4至108个月]）。
多伦多西奈山医院的炎症性肠病中心。
43例患者（29例男性，14例女性）因克罗恩病接受了154次狭窄成形术。患者的平均年龄为32.5岁（范围为17至55岁）。
在十二指肠、小肠及既往吻合部位采用海涅克-米库利兹术式（145次狭窄成形术）或芬尼术式（9次狭窄成形术）进行狭窄成形术。
研究症状复发的相关因素包括既往手术类型、狭窄成形术类型、既往手术次数及疾病部位。
无死亡病例。有1例记录在案的渗漏。26例患者在随访期间无症状。14例患者因进行性梗阻性疾病需要再次手术。所研究变量的差异与症状复发率均无统计学意义。然而，仅接受狭窄成形术这一单一手术的11例患者中只有2例需要再次手术。
狭窄成形术是治疗广泛性梗阻性克罗恩病的一种安全有效的方法。狭窄成形术似乎并未改变该疾病的自然病程。
