Strictureplasty

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Strictureplasty (also spelled Stricturoplasty) is a surgical procedure performed in response to scar tissue that has built up in the intestinal wall from inflammatory bowel conditions such as Crohn's disease. The scar tissue accumulates as a result of repeated damage and healing, with the scarring causing a stricture (a narrowing of the lumen of the bowel). The narrowing can force bowel contents into fissures and ulcers at the site, causing additional damage and narrowing.[1] The surgery restores free flow through the bowel without removing the narrowed segments (i.e., without bowel resection). A narrow segment of bowel is widened by making a cut lengthwise along one side of the bowel, pushing the two ends of the cut together, and then suturing the bowel widthwise. (picture) This has the effect of shortening and widening the segment of bowel, thus resolving the stricture. The process can be repeated at multiple places along the bowel in one surgical session. This procedure can be particularly helpful for those who have already had extensive bowel resection and are at risk for short bowel syndrome.

Strictureplasty was first used to treat Crohn's disease patients about 30 years ago.[2] The procedure is generally safe and effective, and strictures hardly ever recur at the widened areas.[3] However, a large fraction of patients who have any type of surgery for intestinal obstruction due to Crohn's disease will require additional surgery later on, because Crohn's disease is surgically incurable and almost always recurs in undamaged parts of the intestine after the removal of a diseased intestine segment or a stricture.[citation needed]

References[edit]

  1. ^ Fazio VW, et al (1989). "Strictureplasty in Crohn's Disease". Ann. Surg. 210 (5): 621–625. doi:10.1097/00000658-198911000-00009. PMC 1357796. PMID 2818031. 
  2. ^ Lee EC, Papaionnou N. (1982). "Minimal surgery for chronic obstruction in patients with extensive or universal Crohn's disease". Annals of the Royal College of Surgeons of England 64: 229–233. 
  3. ^ Yamamoto T, Fazio VW, Tekkis PP (2007). "Safety and Efficacy of Strictureplasty for Crohn's Disease: A Systematic Review and Meta-Analysis". Dis. Colon Rectum 50 (11): 1968–1986. doi:10.1007/s10350-007-0279-5. PMID 17762967.