Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis : w. Donald buie, m.d., editor.

Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis : w. Donald buie, m.d., editor. Research Abstract Details 

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Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis : w. Donald buie, m.d., editor. Abstract Text:

Takayuki Yamamoto,Victor W Fazio,Paris P Tekkis,Takayuki Yamamoto,Victor W Fazio,Paris P Tekkis,Takayuki Yamamoto,Victor W Fazio,Paris P Tekkis,

PURPOSE: This study was designed to review safety and efficacy of strictureplasty for Crohn's disease. METHODS: A literature search was performed to identify studies published between 1975 and 2005 that reported the outcome of strictureplasty. Systematic review was performed on the following subjects separately: 1) overall experience of strictureplasty; 2) postoperative complications; 3) postoperative recurrence and site of recurrence; 4) factors affecting postoperative complications and recurrence; 5) short-bowel syndrome; and 6) cancer risk. Meta-analysis of recurrence rate after strictureplasty was performed by using random-effect model and meta-regressive techniques. RESULTS: A total of 1,112 patients who underwent 3,259 strictureplasties (Heineke-Mikulicz, 81 percent; Finney, 10 percent; side-to-side isoperistaltic, 5 percent) were identified. The sites of strictureplasty were jejunum and/or ileum (94 percent), previous anastomosis (4 percent), duodenum (1 percent), and colon (1 percent). After jejunoileal strictureplasty, including ileocolonic strictureplasty, septic complications (leak/fistula/abscess) occurred in 4 percent of patients. Overall surgical recurrence was 23 percent (95 percent confidence interval, 17-30 percent). Using meta-regressive analysis, the five-year recurrence rate after strictureplasty was 28 percent. In 90 percent of patients, recurrence occurred at nonstrictureplasty sites, and the site-specific recurrence rate was 3 percent. Two patients developed adenocarcinoma at the site of previous jejunoileal strictureplasty. The experience of duodenal or colonic strictureplasty was limited. CONCLUSIONS: Strictureplasty is a safe and effective procedure for jejunoileal Crohn's disease, including ileocolonic recurrence, and it has the advantage of protecting against further small bowel loss. However, the place for strictureplasty is less well defined in duodenal and colonic diseases.

Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis : w. Donald buie, m.d., editor. Publishing Authors By Initials

T Yamamoto,VW Fazio,PP Tekkis,T Yamamoto,VW Fazio,PP Tekkis,T Yamamoto,VW Fazio,PP Tekkis,

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Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis : w. Donald buie, m.d., editor. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Diseases of the colon and rectum

VOLUME: 50

Page Numbers: 1968-86

Journal Abbreviation: Dis. Colon Rectum

ISSN: 0012-3706

DAY: 8

MONTH: Nov

YEAR: 2007

Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis : w. Donald buie, m.d., editor. Information

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LANGUAGE: eng

NlmUniqueID: 372764

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AFFILIATION: Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, 44195, faziov@ccf.org.

Country: United States

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MEDLINETA: Dis Colon Rectum

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