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.

Description of new "bowel-sparing" techniques for long strictures of Crohn's disease / A. M. Taschieri, M. Cristaldi, M. Elli, P. G. Danelli, B. Molteni, M. Rovati, G. Bianchi Porro. - In: THE AMERICAN JOURNAL OF SURGERY. - ISSN 0002-9610. - 173:6(1997 Jun), pp. 509-512.

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

A. M. Taschieri
Primo
;
M. Cristaldi
Secondo
;
M. Elli;P. G. Danelli;M. Rovati
Penultimo
;
G. Bianchi Porro
Ultimo
1997

Abstract

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.
Intestinal Obstruction; Ileocecal Valve; Anastomosis, Surgical; Colon; Methods; Humans; Crohn Disease; Adult; Ileum; Male; Female
Settore MED/18 - Chirurgia Generale
Settore MED/12 - Gastroenterologia
giu-1997
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/191997
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