炎症性腸疾患に対する外科治療の長期予後　　ＶＩ．Ｃｒｏｈｎ病に対する狭窄形成術：現況とその成績

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  • Current Status and Results of Strictureplasty for Obstructive Crohn's Disease.

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Among 240 patients with Crohn's disease who underwent surgical treatment at Tohoku University Hospital, strictureplasties were performed on 151 patients. At the second operation or thereafter, strictureplasty was selected more frequently. At the initial operation strictureplasties were performed mainly on the ileum. Colon and ileocecal junction operations were also performed but less frequently. At the second operation, previous anastomosis and strictureplasty site were also indicated. The most frequently selected procedure was the Heineke-Mikulicz type. According to the length and rigidity of strictured segment of intestine, various methods were selected. Cumulative risk of reoperation between strictureplasty and anastomotic sites showed no significant difference. Besides, the cumulative risk of reoperation between the patients who underwent intestinal resection alone and those who underwent strictureplasty concomitant with resection showed no significant difference. In the patients who underwent strictureplasty, although the diseased segment was significantly longer, the length of resected intestine was shorter than in the patients who underwent intestinal resection alone, and the length of remnant intestine after surgery was the same between the two groups. These results indicate that strictureplasty has a bowel sparing effect and provides an outcome equivalent to intestinal resection, and so strictureplasty is well indicated for recurrent stricturing disease.

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