Michelassi strictureplasty

The side-to-side isoperistaltic strictureplasty, also now known as the Michelassi stricureplasty, was designed to avoid sacrificing large amounts of small bowel in case of long segments of stricturing Crohn's disease.[1]

Michelassi strictureplasty
Specialtycolorectal surgery

In this strictureplasty the long loop of the bowel affected by Crohn's disease is first divided at its midpoint. The two halves are then moved side to side. A very long opening is created between two loops, which are then sutured together.[2]

The recent extension of this technique to Crohn's disease of the last portion of the small bowel (terminal ileum) going into the right colon is poised to change the paradigm of surgical treatment of terminal ileitis from a conventional resection (ileocolectomy) to a bowel sparing procedure. This technique is now used around the globe.[3] Long-term results with this technique are very satisfactory.[4]

Strictureplasties are categorized into three groups: Conventional, intermediate, and complex procedures. The Heineke-Mikulicz Strictureplasty is the most common among the conventional stricutreplasties, the Finney Strictureplasty is the most common intermediate strictureplasty, and the most common complex strictureplasty is the Michelassi Strictureplasty.

References
  1. Michelassi F (1996). "Side-to-side isoperistaltic strictureplasty for multiple Crohn's strictures". Dis Colon Rectum. 39 (3): 345–349. doi:10.1007/bf02049480. PMID 8603560.
  2. Michelassi F, Hurst RD, Melis M, Rubin M. Cohen R, Gasparitis A. Hanauer SB, Hart J (2000). "Side-to-side isoperistaltic stricturerplasty in extensive Crohn's disease: prospective longitudinal study". Ann Surg. 232 (3): 401–408. doi:10.1097/00000658-200009000-00012. PMC 1421153. PMID 10973390.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. Michelassi F, Taschieri L, Tonelli F, Susaki I, Poggioli G, Ferio V, et al. (2007). "An international, multicenter, prospective, observational study of the side-to-side isoperistaltic strictureplasty in Crohn's disease". J. Dis Colon Rectum. 50 (3): 277–284. doi:10.1007/s10350-006-0804-y. PMID 17245614.
  4. Michelassi, Fabrizio; Mege, Diane; Rubin, Michele; Hurst, Roger D. (2019). "Long-term Results of the Side-to-side Isoperistaltic Strictureplasty in Crohn Disease: 25-year Follow-up and Outcomes". Annals of Surgery. 272 (1): 130–137. doi:10.1097/SLA.0000000000003221. ISSN 0003-4932. PMID 30720502.


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