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J Pediatr Surg ; 47(5): 944-8, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22595578

RESUMO

BACKGROUND/PURPOSE: Surgical resection or strictureplasty (SP) are different options for intestinal Crohn disease (CD) strictures. The aim of this article is evaluation of long-term outcome of SP and resection. METHODS: From 1996 to 2011, 39 patients (23 male, 16 female) with symptomatic ileal and ileocolonic CD strictures resistant to medical/nutritional therapy and treated with surgery in 2 different surgical units were reviewed. The mean age at diagnosis was 11.82 years (range, 4-17 years). Mean age at surgery was 15.94 years (range, 4-24 years). Mean follow-up was 6.88 years (range, 0.5-15 years). Patients underwent resection (group A) or different SP techniques (group B). RESULTS: Twenty patients underwent intestinal resection (ileal or ileocolonic resection), and 19 patients underwent SP (jejunal, ileal, or ileocolic). Early postsurgical complications were observed in 2 patients of group A. Follow-up of group A patients revealed that 1 patient needed emergency treatment after 8 months surgery because of adhesions and 1 patient developed recurrence treated with medical therapy. In the follow-up group B, 3 patients experienced disease recurrence, 2 of them at the site of previous surgery. CONCLUSIONS: At long-term follow-up, no significant difference in relapsing rate was observed between the 2 groups. Strictureplasty and resection represent an effective treatment of pediatric CD strictures. Strictureplasty could represent the first option for intestinal preservation.


Assuntos
Colo/cirurgia , Doenças do Colo/cirurgia , Doença de Crohn/cirurgia , Doenças do Íleo/cirurgia , Íleo/cirurgia , Obstrução Intestinal/cirurgia , Jejuno/cirurgia , Adolescente , Anastomose Cirúrgica , Criança , Pré-Escolar , Doenças do Colo/etiologia , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Doença de Crohn/complicações , Feminino , Seguimentos , Humanos , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Masculino , Complicações Pós-Operatórias , Recidiva , Resultado do Tratamento , Adulto Jovem
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