Efficacy and safety of endoscopic balloon dilation of colorectal strictures remains poorly investigated in Crohn’s disease.
Technical and clinical success of endoscopic balloon dilation of colorectal strictures was high, achieved for 79% and 77%, respectively.
Safety of endoscopic balloon dilation of colorectal strictures is similar to ileal strictures in Crohn’s disease (perforation 0.6% per EDB and 2% per patient).
Endoscopic balloon dilation of Crohn’s disease -associated colorectal strictures is feasible, efficient and safe, with more than 40% becoming asymptomatic without surgery.
While endoscopic balloon dilation (EBD) is widely used to manage ileal strictures, EBD of colorectal strictures remains poorly investigated in Crohn’s disease (CD).
We performed a retrospective study that included all consecutive CD patients who underwent EBD for native or anastomotic colorectal strictures in 9 tertiary centers between 1999 and 2018. Factors associated with EBD failure were also investigated by logistic regression.
Fifty-seven patients (25 women, median age: 36 years (InterQuartile Range, 31-48) were included. Among the 60 strictures, 52 (87%) were native, 39 (65%) measured < 5 cm and the most frequent location was the left colon (27%). Fifty-seven (95%) were non-passable by the scope and 35 (58%) were ulcerated. Among the 161 EBDs performed (median number of dilations per stricture: 2, IQR 1-3), technical and clinical success were achieved for 79% (n = 116/147) and 77% (n = 88/115), respectively. One perforation occurred (0.6% per EDB and 2% per patient). After a median follow-up of 4.3 years (IQR 2.0-8.4), 24 patients (42%) underwent colonic resection and 24 (42%) were asymptomatic without surgery. One colon lymphoma and one colorectal cancer were diagnosed (3.5% of patients) from endoscopic biopsies and at the time of surgery, respectively. No factor was associated with technical or clinical success.
EDB of CD-associated colorectal strictures is feasible, efficient and safe, with more than 40% becoming asymptomatic without surgery.Le texte complet de cet article est disponible en PDF.
Abbreviations : CD, EBD, UC, IBD
Keywords : endoscopic balloon dilatation, Crohn’s disease, colonic strictures