Three-dimensional geometry of the Heineke-Mikulicz strictureplasty.

Inflamm Bowel Dis 2013 Mar-Apr;19(4):704-11

Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Background: The objective of this study was to assess the regional geometry of the Heineke-Mikulicz (HM) strictureplasty. The HM intestinal strictureplasty is commonly performed for the treatment of stricturing Crohn's disease of the small intestine. This procedure shifts relatively normal proximal and distal tissue to the point of narrowing and thus increases the luminal diameter. The overall effect on the regional geometry of the HM strictureplasty, however, has not been previously described in detail.

Methods: HM strictureplasties were created in latex tubing and cast with an epoxy resin. The resultant casts of the lumens were then imaged using computed tomography. Using 3-dimensional vascular reconstruction software, the cross-sectional areas were determined and the surface geometry was examined.

Results: The HM strictureplasty, while increasing the lumen at the point of the stricture, also results in a counterproductive luminal narrowing proximal and distal to the strictureplasty. Within the model used, cross-sectional area was diminished 25% to 50% below baseline. This effect is enhanced when 2 strictureplasties are placed in close proximity to each other.

Conclusions: The HM strictureplasty results in alterations in the regional geometry that may result in a compromise of the lumen proximal and distal to the location of the strictureplasty. When 2 HM strictureplasties are created in close proximity to each other, care should be undertaken to assure that the lumen of the intervening segment is adequate.

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http://dx.doi.org/10.1097/MIB.0b013e3182802be3DOI Listing
September 2013
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References

(Supplied by CrossRef)

Yamamoto et al.
Dis Colon Rectum 2007

Alexander-Williams et al.
Int J Colorectal Dis 1986

Witten et al.
Rev Mod Phys 2007

Dietz et al.
Dis Colon Rectum 2002

Fazio et al.
Dis Colon Rectum 1993

Hurst et al.
World J Surg 1998

Hashemi et al.
Dis Colon Rectum 1998

Ikeuchi et al.
Dig Surg 2000

Tersigni et al.
Does stapled functional end-to-end anastomosis affect recurrence of Crohns disease after ileocolonic resection Hepatogastroenterology 2003

Yamamoto et al.
Scand J Gastroenterol 1999

Kono et al.
Dis Colon Rectum 2011

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