Strictureplasty
Encyclopedia
Strictureplasty is a surgical procedure performed in response to scar tissue that has built up in the intestinal wall from inflammatory bowel conditions such as Crohn's disease
. The scar tissue accumulates as a result of repeated damage and healing, with the scarring causing a stricture
(a narrowing of the lumen
of the bowel). The narrowing can force bowel contents into fissures and ulcers at the site, causing additional damage and narrowing. The surgery restores free flow through the bowel without removing the narrowed segments (i.e., without bowel resection
). A narrow segment of bowel is widened by making a cut lengthwise along one side of the bowel, pushing the two ends of the cut together, and then suturing the bowel widthwise. (picture) This has the effect of shortening and widening the segment of bowel, thus resolving the stricture. The process can be repeated at multiple places along the bowel in one surgical session. This procedure can be particularly helpful for those who have already had extensive bowel resection
and are at risk for short bowel syndrome
.
Strictureplasty was first used to treat Crohn's disease patients about 30 years ago. The procedure is generally safe and effective, and strictures hardly ever recur at the widened areas. However, a large fraction of patients who have any type of surgery for intestinal obstruction due to Crohn's disease
will require additional surgery later on.
Crohn's disease
Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...
. The scar tissue accumulates as a result of repeated damage and healing, with the scarring causing a stricture
Stenosis
A stenosis is an abnormal narrowing in a blood vessel or other tubular organ or structure.It is also sometimes called a stricture ....
(a narrowing of the lumen
Lumen (anatomy)
A lumen in biology is the inside space of a tubular structure, such as an artery or intestine...
of the bowel). The narrowing can force bowel contents into fissures and ulcers at the site, causing additional damage and narrowing. The surgery restores free flow through the bowel without removing the narrowed segments (i.e., without bowel resection
Bowel resection
A bowel resection is a surgical procedure in which a part of the large or small intestine is removed. It may be performed due to cancer, necrosis, enteritis, diverticular disease, or a block in the intestine due to scar tissue...
). A narrow segment of bowel is widened by making a cut lengthwise along one side of the bowel, pushing the two ends of the cut together, and then suturing the bowel widthwise. (picture) This has the effect of shortening and widening the segment of bowel, thus resolving the stricture. The process can be repeated at multiple places along the bowel in one surgical session. This procedure can be particularly helpful for those who have already had extensive bowel resection
Bowel resection
A bowel resection is a surgical procedure in which a part of the large or small intestine is removed. It may be performed due to cancer, necrosis, enteritis, diverticular disease, or a block in the intestine due to scar tissue...
and are at risk for short bowel syndrome
Short bowel syndrome
Short bowel syndrome is a malabsorption disorder caused by the surgical removal of the small intestine, or rarely due to the complete dysfunction of a large segment of bowel. Most cases are acquired, although some children are born with a congenital short bowel...
.
Strictureplasty was first used to treat Crohn's disease patients about 30 years ago. The procedure is generally safe and effective, and strictures hardly ever recur at the widened areas. However, a large fraction of patients who have any type of surgery for intestinal obstruction due to Crohn's disease
Crohn's disease
Crohn's disease, also known as regional enteritis, is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms...
will require additional surgery later on.