Plastias de estenoses jejunais, ileais e ileocecais na doença de Crohn : analise de resultados imediatos e tardios / Jejunal, ileal and ileocecal strictureplasty as the surgical treatment of Crohn s disease

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

Strictureplasty is an altemative surgical procedure for Crohn s disease, particulary in patients with previous resections or many intestinal stenosis. The aim of this tudy was to analyze surgical complications and clinical follow-up in patients submitted to strictureplasty secondary to Crohn s disease. Twenty-eight patients (57,1% male, mean age 33,3 years, range 16-54 years) with Crohn s disease and intestinal stenosis (small bowel, ileocecal region and ileocolic anastomosis) were submitted to strictureplasty,at one institution,betweenseptember1991and may2004. Sixteeenpatients had previous surgical procedures for Crohn s disease and 13 with intestinal resections. The mean follow-up was 58,1 months. A total of 116 strictureplasties were done (94 Heineke-Mikulicz - 81%, 15 Finney - 13%, seven side-to-side ileocolic strictureplasty - 6%). Three patients were submitted to strictureplasty at two different surgical procedures and two in three procedures. Regarding to strictureplasty, postoperative complication rate was 57,1%, with three suture leaks (10,7%) and late was present in two patients, both with incisional hemial and enterocutaneous fistulas (28,6%). Patients remainded hospitalized during a medium time of 12,4 days. Clinical and surgical recurrence rates were 63~ and 41%, respectively. Among the patients submitted to another surgery, two patients had two more operations and one had three. Recurrence rate at strictureplasty site was observed in 3,5%, being Finney techinique the commonest one. Presently, 19 patients had been asymptomatic with the majority of them under medical therapy. In conclusion, strictureplasties have low complicating rates, in spite of having been done at compromised site, with long term pain relief. Considering the clinical course of Crohn s disease, with many patients being submitted to intestinal resections, strictureplasties should be considered as an effective surgical treatment to spare long intestinal resections

ASSUNTO(S)

estenose cirurgia doença de surgery inflamatory bowel disease stricture crohn s diseases crohn intestinos - doenças

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