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Strictureplasty may lead to increased preference in the surgical management of Crohn’s disease: a case-matched study

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Abstract

Background

Resection and strictureplasty are the two surgical modalities used in the management of Crohn’s disease (CD). The objective of this study was to compare morbidity and clinical recurrence between patients who underwent strictureplasty and patients who underwent resection.

Methods

Patients with CD who underwent strictureplasty between January 2012 and December 2022 were enrolled. The patients were well matched with patients who underwent resection without strictureplasty. Patient- and disease-specific characteristics, postoperative morbidity, and clinical recurrence were also analyzed.

Results

A total of 118 patients who underwent a total of 192 strictureplasties were well matched to 118 patients who underwent resection. The strictureplasty group exhibited significantly less blood loss (30 ml versus 50 ml, p < 0.001) and stoma creation (2.5% versus 16.9%, p < 0.001). No significant difference was found regarding postoperative complications or length of postoperative stay. At the end of the follow-up, the overall rate of clinical recurrence was 39.4%, and no difference was observed between the two groups. Postoperative prophylactic use of biologics (odds ratio = 0.2, p < 0.001) was the only protective factor against recurrence.

Conclusion

Strictureplasty does not increase the risk of complications or recurrence compared with resection. It represents a viable alternative to resection in selected patients, and as such, it should have a broader scope of indications and greater acceptance among surgeons.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, Zhejiang Province, People’s Republic of China

    W. Liu, W. Zhou, X. Ge, W. Qi, T. Lin & L. Cao

  2. Inflammatory Bowel Disease Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China

    W. Liu, W. Zhou, X. Ge, W. Qi & Q. Cao

  3. School of Medicine, Shantou University, Shantou, 515063, Guangdong Province, China

    Y. Zhang

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  1. W. Liu
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  8. L. Cao
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Contributions

W.L. and W.Z. conceived the study. Y.Z., X.l.G., and W.l.Q. collected the data. T.Y.L. and Q.C. analyzed the data and all authors critically interpreted the data. W.L. assisted in statistical analysis. W.L. and L.P.C. drafted the manuscript. All authors critically reviewed and revised the manuscript. All authors approved the final manuscript.

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Correspondence to W. Zhou or L. Cao.

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Conflict of interest

None of the authors has any conflicts of interest or financial ties to disclose.

Ethical approval and Informed consent

Written informed consent was obtained from the patients and this study was approved by the Experts Committee of Sir Run Run Shaw Hospital (2023–0285).

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Liu, W., Zhou, W., Zhang, Y. et al. Strictureplasty may lead to increased preference in the surgical management of Crohn’s disease: a case-matched study. Tech Coloproctol 28, 40 (2024). https://doi.org/10.1007/s10151-024-02915-5

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