Follow up of more than 10 years after strictureplasty for jejunoileal Crohn’s disease: long‐term results and predictive factors for outcome

Abstract

The long-term outcome of strictureplasty for Crohn's disease is unknown. There have been few reports that have examined the predictive factors for outcome after strictureplasty. This study was undertaken to assess the long-term results and predictive factors for outcome following strictureplasty for jejunoileal Crohn's disease. Thirty-eight patients who underwent primary strictureplasty for jejunoileal Crohn's disease between 1980 and 1987 were reviewed. Four patients developed an enterocutaneous fistula, of whom two had an intra-abdominal abscess. Two patients died during this study (one from leukaemia and another from small bowel carcinoma) and one patient was lost to follow up. All other patients have been followed for> 10 years. The 5- and 10-year cumulative reoperation rates for recurrence at the previous jejunoileal strictureplasty sites (site-specific recurrence) were 26% and 29%, respectively, after a median follow up of 13.5 years. After 5 years only one patient required surgery for site-specific recurrence. The only factor associated with a high rate of reoperation for site-specific recurrence was youth (<35 years). Gender, duration of symptoms, smoking habits, preoperative steroids therapy, preoperative albumin level, intra-abdominal abscess at laparotomy, number or length of strictureplasties, or previous or synchronous small bowel resection did not affect the reoperation rate. Strictureplasty is a safe and efficacious procedure for jejunoileal Crohn's disease in the long term. Recurrence tends to develop early after strictureplasty, and late recurrence is uncommon. Only youth was a significant risk factor for site-specific recurrence requiring reoperation.