Quality of Life after Surgical Therapy of Small Bowel Stenosis in Crohn’s Disease

Abstract

Background: Improvement in quality of life is one of the important determinants in the treatment of Crohn’s disease. Since there is no cure with radical resection of inflamed bowel, strictureplasty has become a useful surgical technique in the treatment of small bowel obstruction. The scope of this study was to define the results of strictureplasty and resection in terms of quality of life, surgical recurrence and postoperative complications. Methods: The charts of 67 patients with Crohn’s disease of the small bowel were analyzed retrospectively. Patients were treated either by strictureplasty (group A) or resection (group B). Quality of life was evaluated in follow-up examinations using the Inflammatory Bowel Disease Questionnaire (IBDQ). Results: Postoperative morbidity was 14.8% after strictureplasty and 17% after resection (p = 0.8). 50% of the patients treated by strictureplasty and 37% treated by resection developed recurrent disease (p = 0.40). Quality-of-life measurement revealed no significant difference between patients treated by strictureplasty or resection. Conclusion: Results after strictureplasty are comparable to those after resection in terms of complications, recurrence and quality of life in the treatment of small bowel strictures in Crohn’s disease. In the long run there might be an advantage for strictureplasty because it prevents complications caused by resectional therapy such as short bowel syndrome.

Long-term efficacy of strictureplasty for Crohn’s disease

“…Although the recurrence rate at the site of SP was lower than that at the site of the resection in this study, others found no signifi cant differences among recurrence rates after a SP alone, SP plus a resection, and a resection alone. 11,12,17,[19][20][21][22] On the other hand, Borley et al 23 reported a signifi cantly shorter period to reoperation for patients treated with SP alone or SP plus resection in comparison to those treated with a resection alone. It is generally considered that the recurrence rate would be higher after the SP procedure, since the diseased intestine remains.…”

Difference in Recurrence Patterns Between Anastomosis and Strictureplasty After Surgical Treatment for Crohn Disease

“…Controversy exists on the recurrence rate after strictureplasty and resection. 16,[18][19][20][21][22][23] Several invesigators 18,19 have reported no significant differences in rates of recurrence after strictureplasty versus resection. No significant difference is also reported in the recurrence rate after strictureplasty alone and strictureplasty plus resection.…”

Quality-of-life estimation by Polish and American inflammatory bowel diseases patients – pilot study

“…The latter make up an important link towards planning the diagnostic process and constitute a crucial therapeutic hint. A key element of treatment is to increase the quality of a patient's life; therefore, the therapy programme should include this aspect [10][11][12][13][14]. Consequently, the realization of the expectations and opinions of the patients constitutes an important factor of a physician's procedures.…”