Resection Leads to Less Recurrence Than Strictureplasty in a Paediatric Population with Obstructive Crohn’s DiseaseReportar como inadecuado




Resection Leads to Less Recurrence Than Strictureplasty in a Paediatric Population with Obstructive Crohn’s Disease - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Surgery Research and Practice - Volume 2014 2014, Article ID 709045, 5 pages -

Research ArticleDepartment of General and Colorectal Surgery, St George’s Healthcare NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, UK

Received 25 September 2013; Revised 16 December 2013; Accepted 23 February 2014; Published 1 April 2014

Academic Editor: Sebastiaan W. Polle

Copyright © 2014 Richard Bamford et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Resection and strictureplasty are used to treat patients with obstructive Crohn’s disease. Strictureplasty is preferable in adults as it retains bowel length. This study aims to identify differences in outcomes of children undergoing strictureplasty and resection for obstructive Crohn’s disease. Method. Patients under 20 years undergoing surgery over a nine-year period were included. Data was collected on procedures for stenotic Crohn’s disease. Patients were divided into 2 groups: Group 1 treated with strictureplasties and Group 2 resections. Postoperative complications and recurrence rates were recorded. Kaplan-Meier method was used to analyze the data. Results. Twenty-six patients and 40 operations were identified. Mean age was 15.6 years 7.2–19.4 with equal numbers of males and females. Mean follow-up was 45.9 months 0.1–149.9. 20-40 procedures involved the terminal ileum; 9-40, the ileocolic junction; 8-40, the upper GI tract; and 3-40, the colon. Group 1 consisted of 19 strictureplasties and Group 2 consisted of 13 resections and 8 combined procedures. Significantly more patients in Group 1 required further surgery 11-19 versus 3-21; . Conclusion. Allowing for variations in disease duration, severity, and previous medical management, these data suggest that resection is preferable to strictureplasty in treating obstructive Crohn’s disease in children and adolescents.





Autor: Richard Bamford, Ashley Hay, and Devinder Kumar

Fuente: https://www.hindawi.com/



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