Journal
COLORECTAL DISEASE
Volume 18, Issue 8, Pages O311-O313Publisher
WILEY-BLACKWELL
DOI: 10.1111/codi.13420
Keywords
Terminal ileitis; Crohn's disease; strictureplasty; Michelassi; bowel sparing technique
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AimThe study describes the technique of a modified side-to-side isoperistaltic strictureplasty over the ileocaecal valve. MethodThe technical details of a modified side-to-side isoperistaltic strictureplasty of the terminal ileum for stricturing Crohn's disease is described including Figs.1 and 2 and a video illustration (Video S1). ResultsBetween November 2010 and December 2015, 36 patients underwent a side-to-side isoperistaltic strictureplasty of the (neo-)terminal ileum (men 14/36; median age 35years [interquartile range (IQR) 26-51years]). Thirty were operated by either multiport or single port laparoscopy. The median length of hospital stay was 9 (IQR 8-11)days. Anastomotic leakage occurred in two patients both in the first five cases. In both the anastomosis could be rescued by additional suturing. After a median follow-up of 18.9 (IQR 7.0-36.0)months, 14 patients had developed clinical recurrence and one had a surgical recurrence at 63months. ConclusionA modified side-to-side isoperistaltic strictureplasty is a feasible and safe technique, rendering maximal bowel sparing surgery possible.
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