Strictureplasty for Treatment of Crohn’s Disease

an ACS-NSQIP Database Analysis

Cristina B. Geltzeiler, J. Isaac Young, Brian S. Diggs, Kian Keyashian, Karen Deveney, Kim Lu, Vassiliki Tsikitis, Daniel Herzig

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: Strictureplasty is an alternative to resection for treatment of Crohn’s disease (CD) strictures. It preserves bowel length, and specialized centers report favorable outcomes. Strictureplasty rates, however, are thought to be low, and it was recently removed from required cases for colon and rectal surgery residents. We examined operative characteristics, and trends in its use using a large national database. Materials and Methods: We examined the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2012, identifying patients with CD who underwent strictureplasty. We identified patient characteristics, outcome variables, and trends in utilization of strictureplasty. Results: A total of 9172 patients underwent surgery for CD. Two hundred fifty-six (2.8 %) underwent strictureplasty. Median preoperative albumin was 3.6. Preoperative steroid use and weight loss rates were 39 and 8 %. Rates of wound infection and organ space infection were 11 and 4 %. Rate of reoperation was 6 %. Outcomes did not change significantly over time (all p = NS). The proportion of CD operations that included a strictureplasty decreased from 5.1 to 1.7 % (OR 0.902 with each additional year, 95 % CI (0.852, 0.960), p <0.001). Conclusion: Strictureplasty as treatment for CD is decreasing in the ACS-NSQIP database. Infectious complications and reoperation rates following strictureplasty are low and have not changed over time.

Original languageEnglish (US)
Pages (from-to)905-910
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Quality Improvement
Crohn Disease
Databases
Reoperation
Therapeutics
Wound Infection
Weight Loss
Albumins
Pathologic Constriction
Colon
Steroids
Surgeons
Infection

Keywords

  • ACS-NSQIP
  • Crohn’s
  • Small bowel
  • Strictureplasty
  • Trends

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Strictureplasty for Treatment of Crohn’s Disease : an ACS-NSQIP Database Analysis. / Geltzeiler, Cristina B.; Young, J. Isaac; Diggs, Brian S.; Keyashian, Kian; Deveney, Karen; Lu, Kim; Tsikitis, Vassiliki; Herzig, Daniel.

In: Journal of Gastrointestinal Surgery, Vol. 19, No. 5, 01.05.2015, p. 905-910.

Research output: Contribution to journalArticle

Geltzeiler, Cristina B. ; Young, J. Isaac ; Diggs, Brian S. ; Keyashian, Kian ; Deveney, Karen ; Lu, Kim ; Tsikitis, Vassiliki ; Herzig, Daniel. / Strictureplasty for Treatment of Crohn’s Disease : an ACS-NSQIP Database Analysis. In: Journal of Gastrointestinal Surgery. 2015 ; Vol. 19, No. 5. pp. 905-910.
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