Strictureplasty

Strictureplasty (also spelled Stricturoplasty) 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.^[1] 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.^[2] The procedure is generally safe and effective, and strictures hardly ever recur at the widened areas.^[3] 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, because Crohn's disease is surgically incurable and almost always recurs in undamaged parts of the intestine after the removal of a diseased intestine segment or a stricture.

References

↑ Fazio VW, et al. (1989). "Strictureplasty in Crohn's Disease". Ann. Surg. 210 (5): 621–625. doi:10.1097/00000658-198911000-00009. PMC 1357796. PMID 2818031.
↑ Lee EC, Papaionnou N. (1982). "Minimal surgery for chronic obstruction in patients with extensive or universal Crohn's disease". Annals of the Royal College of Surgeons of England 64: 229–233.
↑ Yamamoto T, Fazio VW, Tekkis PP (2007). "Safety and Efficacy of Strictureplasty for Crohn's Disease: A Systematic Review and Meta-Analysis". Dis. Colon Rectum 50 (11): 1968–1986. doi:10.1007/s10350-007-0279-5. PMID 17762967.

Surgical procedures involving the digestive system (ICD-9-CM V3 42–54, ICD-10-PCS 0D)

Digestive tract

Upper GI tract

SGs / Esophagus	Esophagectomy Heller myotomy Sialography Impedance–pH monitoring Esophageal pH monitoring Esophageal motility study

Stomach	Bariatric surgery Adjustable gastric band Gastric bypass surgery Sleeve gastrectomy Vertical banded gastroplasty surgery Collis gastroplasty Gastrectomy Billroth I Billroth II Roux-en-Y Gastroenterostomy Gastropexy Gastrostomy Percutaneous endoscopic gastrostomy Hill repair Nissen fundoplication Pyloromyotomy

Medical imaging	Endoscopy: Esophagogastroduodenoscopy Barium swallow Upper gastrointestinal series

Lower GI tract

Small bowel	Bariatric surgery Duodenal switch Jejunoileal bypass Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery

Large bowel	Appendicectomy Colectomy Colonic polypectomy Colostomy Hartmann's operation

Rectum	Abdominoperineal resection / Miles operation Lower anterior resection Total mesorectal excision

Anal canal	Anal sphincterotomy Anorectal manometry Lateral internal sphincterotomy Rubber band ligation Transanal hemorrhoidal dearterialization

Medical imaging	Endoscopy: Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy

Stool tests	Fecal fat test Fecal pH test Stool guaiac test

Accessory

Liver	Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure

Gallbladder, bile duct	Cholecystectomy Cholecystostomy ERCP Hepatoportoenterostomy Medical imaging: Cholangiography IV MRCP PTC Cholecystography Cholescintigraphy

Pancreas	Frey's procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure

Abdominopelvic

Peritoneum	Diagnostic peritoneal lavage Intraperitoneal injection Laparoscopy Omentopexy Paracentesis Peritoneal dialysis

Hernia	Hernia repair: Inguinal hernia surgery Femoral hernia repair

Other

CPRs

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