Abstracts
1998 Digestive Disease Week

#995

STRICTUREPLASTIES FOR COLONIC STENOSIS IN CROHN'S DISEASE. Yuji Funayama, Iwao Sasaki, Hiroo Naito, Kohei Fukushima, Chikasi Shibata, Tuyoshi Masuko, Kein-ichi Takahashi, Hitoshi Ogawa, Shun Sato, Tatsuya Ueno, Akihiko Hashimoto, and Seiki Matsuno. The First Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.

Background and Aim: Strictureplasties (SXPLs) are mainly used for stenosis of the small intestine. Expanding the indication, we applied SXPL also to the stricture of colon or ileocolic junction. To evaluate the results of SXPLs in the colon, we analyzed the postoperative course and complications.

Patients and Methods: Since May 1991, eighteen operations using SXPLs were performed against the stricture of the colon, ileocecal valve, and previous ileocolic anastomosis for seventeen patients (14 males and 3 females). Median age at operation was 32.9 (range 19.6-59.4) years, and median postoperative follow-up period was 34.9 months (range 3.8-75.4). Twelve patients had ileocolitis, four had ileitis, and one had colitis. Initial operation was done in eight cases, the second operation in four, the third operation in three, the fourth operation in two, and the fifth operation in one each. SXPL was applied to relatively short stenosis without fistula, abscess or phlegmonous inflammation. In seven operations with stenosis of the colon, stenosis was located in ascending colon in five, transverse colon in one, and splenic flexture in one. Heineke-Mikulics type SXPL was performed in three patients, Finney type in three, and Jaboulay type in one. In seven operations with stenosis in ileocecal valve, Heineke-Mikulics type SXPL was performed in three, Jaboulay type in three, and side-to-side SXPL in one. In four operations with stenosis in previous ileocolic anastomosis, Heineke-Mikulics type SXPL was performed in three, and Jaboulay type in one.

Results: In seven patients with stenosis of colon, median follow-up period was 35.2 months(range 7.0-71.1). Reoperation was done in two patients due to the other sites of strictures. in seven patients with stenosis in ileocecal valve, median follow-up period was 35.0 months (range 3.8-71.1). Reoperation was performed in only one patient due to another SXPL site. In four patients with stenosis in previous ileocolic anastomosis, median follow-up period was 52.3 months (range 31.6-75.4). Reoperation was performed in one patient due to stricture of the SXPL site 75.4 month later. Post operative complications including fistula or abscess formation were not observed in any of these patients. In eighteen SXPLs in the colon, reoperation was needed in only one site after six-year-follow-up.

Conclusion: Strictureplasty was a safe and useful procedures even in the colonic stenosis. Long-term results were satisfactory up to six years.

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.