Modified side‐to‐side isoperistaltic strictureplasty over the ileocaecal valve for the surgical treatment of terminal ileal Crohn's disease: the ultimate bowel sparing technique?

Aim The study describes the technique of a modified side‐to‐side isoperistaltic strictureplasty over the ileocaecal valve. Method The technical details of a modified side‐to‐side isoperistaltic strictureplasty of the terminal ileum for stricturing Crohn's disease is described including Figs. 1 and 2 and a video illustration (Video S1). Results Between November 2010 and December 2015, 36 patients underwent a side‐to‐side isoperistaltic strictureplasty of the (neo‐)terminal ileum (men 14/36; median age 35 years [interquartile range (IQR) 26−51 years]). Thirty were operated by either multiport or single port laparoscopy. The median length of hospital stay was 9 (IQR 8−11) days. Anastomotic leakage occurred in two patients both in the first five cases. In both the anastomosis could be rescued by additional suturing. After a median follow‐up of 18.9 (IQR 7.0−36.0) months, 14 patients had developed clinical recurrence and one had a surgical recurrence at 63 months. Conclusion A modified side‐to‐side isoperistaltic strictureplasty is a feasible and safe technique, rendering maximal bowel sparing surgery possible.