Surgical endoscopy · 2026
Intraoperative endoscopic stricturotomy combined with strictureplasty for multiple small bowel strictures in Crohn's disease: a pilot case series.
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Zhongcheng Liu, Sicong Lai, Bo Peng, Jia Ke, Qin Guo
Аннотация
BACKGROUND: To investigate the safety and feasibility of strictureplasty combined with intraoperative endoscopic stricturotomy in the surgical treatment of multiple strictures of the small bowel in Crohn's disease (CD).
METHODS: We retrospectively analyzed clinical data from 12 CD patients who underwent strictureplasty combined with intraoperative endoscopic stricturotomy at the Sixth Affiliated Hospital of Sun Yat-Sen University between August 2023 and November 2025 to examine surgical conditions and short-term prognosis.
RESULTS: A total of 12 patients were included in our study (including 8 males and 4 females), with a mean age of (31.6 ± 6.4) years and a mean disease duration of (61.2 ± 49.1) months. A total of 19 strictureplasties, all of which were Heineke-Mikulicz (H-M) strictureplasties, and 53 intraoperative endoscopic stricturotomy were performed in the small bowel of 12 patients. Successful endoscopic stricturotomy was defined as passage of the endoscope after stricturotomy. No complications such as fistulae, bleeding, or perforation occurred in any patient postoperatively during the postoperative hospital stay. The median hospital stay following surgery was 7 days.
CONCLUSION: Strictureplasty combined with intraoperative endoscopic stricturotomy is a safe and feasible surgical procedure for the treatment of multiple strictures of the small bowel in Crohn's disease, which can effectively reduce the risk of short bowel syndrome, and appears feasible in selected patients, but larger studies with longer follow-up are needed.
METHODS: We retrospectively analyzed clinical data from 12 CD patients who underwent strictureplasty combined with intraoperative endoscopic stricturotomy at the Sixth Affiliated Hospital of Sun Yat-Sen University between August 2023 and November 2025 to examine surgical conditions and short-term prognosis.
RESULTS: A total of 12 patients were included in our study (including 8 males and 4 females), with a mean age of (31.6 ± 6.4) years and a mean disease duration of (61.2 ± 49.1) months. A total of 19 strictureplasties, all of which were Heineke-Mikulicz (H-M) strictureplasties, and 53 intraoperative endoscopic stricturotomy were performed in the small bowel of 12 patients. Successful endoscopic stricturotomy was defined as passage of the endoscope after stricturotomy. No complications such as fistulae, bleeding, or perforation occurred in any patient postoperatively during the postoperative hospital stay. The median hospital stay following surgery was 7 days.
CONCLUSION: Strictureplasty combined with intraoperative endoscopic stricturotomy is a safe and feasible surgical procedure for the treatment of multiple strictures of the small bowel in Crohn's disease, which can effectively reduce the risk of short bowel syndrome, and appears feasible in selected patients, but larger studies with longer follow-up are needed.