Endoscopic management of Crohn's disease intestinal strictures with balloon dilation is effective.
However, recurrences are frequent and require further dilations or surgery.
The use of extractible metallic stents may be as effective as balloon dilation with fewer recurrences.
Dr Alain Attar and colleagues investigated in a prospective pilot study the feasibility and clinical effectiveness of the use of extractible stents in the treatment of Crohn's disease intestinal strictures.
In 2 tertiary referral centers, quiescent Crohn's disease patients except for obstructive symptoms associated with intestinal stenosis of less than 50 mm length on enterography were eligible for transitory stent placement.
The team initially planned to retrieve patients after 8 weeks, which was secondarily reduced to 4 weeks after patient 3.
|Obstructive symptoms were relieved in 6 out of 10 patients|
|Inflammatory Bowel Disease|
The researchers prospectively included 11 patients.
The sites of intestinal stenosis were an ileocolonic anastomosis, an ileosigmoidic anastomosis, and the surgically untreated terminal ileum in 8, 1, and 2 patients, respectively.
The research team found that stent placement was technically successful in 10 patients.
Obstructive symptoms were relieved in 6 out of 10 patients.
The team noted that 2 patients needed surgery related to the procedure.
The research team observed 6 downstream migrations.
Only 1 patient could have the stent extracted as scheduled on day 28 and remains symptom-free after 73 months of follow-up.
Dr Attar's team concludes, "Even if stenting appears an effective technique in treating symptomatic Crohn's disease intestinal strictures, the procedure is associated with a prohibitively high rate of spontaneous migrations and complications."