Endoscopic balloon dilation of colorectal strictures complicating Crohn’s disease: a multicenter study - 17/11/20
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Highlights |
• | 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. |
Abstract |
Introduction |
While endoscopic balloon dilation (EBD) is widely used to manage ileal strictures, EBD of colorectal strictures remains poorly investigated in Crohn’s disease (CD).
Methods |
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.
Results |
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.
Conclusion |
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
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