Strictureplasty

Strictureplasty is a surgical procedure used to treat bowel obstruction caused by intestinal strictures, which are narrowings of the intestine. This technique is commonly employed in patients with Crohn's disease, a type of inflammatory bowel disease (IBD), but it can also be used for other conditions that cause strictures in the intestines.

Indications

Strictureplasty is indicated for patients with symptomatic intestinal strictures that cause obstructive symptoms such as abdominal pain, nausea, vomiting, and bloating. It is particularly useful in patients with multiple strictures or those who have had previous bowel resections, as it preserves bowel length and function.

Procedure

The procedure involves making a longitudinal incision along the length of the stricture and then closing it transversely. This widens the narrowed segment of the intestine without removing any part of it. There are several types of strictureplasty techniques, including:

• Heineke-Mikulicz strictureplasty: Used for short strictures, typically less than 10 cm in length.
• Finney strictureplasty: Suitable for longer strictures, usually between 10 and 20 cm.
• Jaboulay strictureplasty: Applied to very long strictures or multiple close strictures.

Advantages

Strictureplasty offers several advantages over bowel resection, including:

• Preservation of bowel length, which is crucial for maintaining adequate nutrient absorption.
• Reduced risk of developing short bowel syndrome, a condition that can occur after extensive bowel resection.
• Lower recurrence rates of strictures compared to resection.

Complications

As with any surgical procedure, strictureplasty carries potential risks and complications, such as:

• Infection
• Bleeding
• Anastomotic leak
• Recurrence of strictures
• Fistula formation

Postoperative Care

Postoperative care involves monitoring for signs of complications, managing pain, and gradually reintroducing oral intake. Patients are typically advised to follow a specific diet and may require medications to manage their underlying condition, such as immunosuppressive drugs for Crohn's disease.

Related Pages

• Crohn's disease
• Inflammatory bowel disease
• Bowel obstruction
• Intestinal stricture
• Short bowel syndrome