Crohn's Disease Surgery - Strictureplasty

Patients who have had multiple previous intestinal resections or who have multiple segments of affected small intestine are at risk of developing short bowel syndrome if they have more of their bowel removed surgically. A strictureplasty is a method of avoiding removal of additional segments of intestine. There are a number of methods of performing strictureplasty, but they all involve opening up the affected and narrowed segment of the intestine and creating a larger internal passageway for food to pass through without causing symptoms of obstruction.

Strictureplasty is not always done whenever there is a narrowed segment of small intestine for several reasons. The affected segment is often too long — multiple short segments of narrowing are ideal for strictureplasty. The segment is sometimes too diseased and thickened, making it difficult to work with surgically. There may be only a single short segment of narrowing, and the risk of the strictureplasty procedure (leak, infection, recurrent obstruction) is not worth the potential benefit of avoiding a resection, which is generally much easier to perform. In the situation where the segment is very short, resection of that segment carries very little risk of complication or of future development of short bowel syndrome.