Side-to-Side Isoperistaltic Strictureplasty Helpful in Crohn's
Age at diagnosis and surgery, family history, smoking are independent risk factors for recurrence
TUESDAY, Jan. 5, 2016 (HealthDay News) -- For patients with Crohn's disease (CD), side-to-side isoperistaltic strictureplasty (SSIS) is beneficial, with acceptable recurrence rates, according to a study published online Dec. 30 in JAMA Surgery.
Marilena Fazi, M.D., from the University of Florence in Italy, and colleagues examined the results obtained in a monocentric population of 91 patients with CD who underwent SSIS (mean age, 39.5 years; mean preoperative disease duration, 97.9 months). The procedure was performed according to the Michelassi technique in 69 patients and according to the Tonelli technique in 22 patients.
Follow-up data were available for 91.2 percent of patients, of whom 44.58 percent experienced recurrence at a mean of 55.46 months postoperatively. The researchers found that, overall, 28.9 percent of patients experienced recurrence at the SSIS site, which occurred at a mean of 48.25 months after surgery (nine medical and 15 surgical recurrence cases). There was a significant association for recurrence in the SSIS with time elapsed between diagnosis and surgery (P = 0.03). There was a borderline correlation between family history of CD and surgical recurrence (P = 0.054). In multivariate analysis, independent risk factors for recurrence were found to be age at diagnosis (P = 0.02), age at surgery (P = 0.005), family history (P = 0.01), and smoking habit (P = 0.007).
"In the short-term, SSIS leads to a resolution of symptoms in more than 90 percent of cases and the recurrence rate in the SSIS area is acceptable, even after long-term follow-up," the authors write.