Pioneer reports on better surgery for Crohn's disease

Reported by Susan Aldridge, PhD, medical journalist

Study shows how to manage complication after Crohn's disease surgery.
Crohn's disease involves chronic inflammation of the colon, leading to pain and diarrhea and often requiring surgery. Dr Fabrizio Michelassi of the New York Presbyterian Hospital has developed a new procedure for dealing with one of the complications of the disease, known as bowel strictures. These are narrowings of the bowel which may require surgery, but which often recur after the operation. Dr Michelassi's procedure is called strictureplasty and it spares the bowel. He has noted the progress of patients having strictureplasty over the last two decades.

His findings show that strictureplasty does carry a lower risk of stricture recurrence than does conventional surgery. Recurrence tends to happen much later, too, with the bowel-sparing procedure. Such recurrences are also less likely to require a surgical excision of the affected area than those occurring after conventional surgery. Dr Michelassi also advises on prophylactic strictureplasty - a procedure which may be able to pre-empt stricture related problems. He suggests that it may be worthwhile treating strictures without symptoms if this can be done with the bowel-sparing procedure, as it will lead to later problems in about 25 per cent of cases. If conventional surgery would be needed, however, he suggests leaving well alone. It's to be hoped that Crohn's disease patients can benefit from this more rational approach to treating their condition, based on Dr Michelassi's experience.

Source
Surgery February 2007

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