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Endoscopic treatment with self-expanding metal stents is safe in Crohn's

The latest issue of the Alimentary Pharmacology & Therapeutics examines endoscopic treatment with self-expanding metal stents for Crohn's disease strictures.

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Balloon dilation is the endoscopic treatment of choice for short strictures in Crohn's disease.

The placement of a stent has only rarely been reported in this setting, and it may be a good alternative.
 
Dr Loras and colleagues from Spain described the efficacy of temporary placement of a self-expanding metallic stent in the endoscopic treatment of symptomatic strictures in Crohn's disease.
 
The research team included 17 Crohn's disease patients treated with self-expanding metallic stent for symptomatic strictures refractory to medical and/or endoscopic treatment.
 
The researchers placed 25 stents in 17 patients with stenosis, in the colon and in the ileocolonic anastomosis.

Treatment was effective in 65% of the patients
Alimentary Pharmacology & Therapeutics

In two cases, 2 stents were placed in the same endoscopic procedure.

All except 3 cases had previously been unsuccessfully treated with endoscopic dilatation.

The team reported that the stents were maintained for an average of 28 days.

The researchers found that treatment was effective in 65% of the patients after a mean follow-up time of 60 weeks.

In 4 cases, the team observed that removal of the stents was technically difficult due to stent impaction, and 1 patient had a proximal stent migration requiring delayed surgery.
 
Dr Loras' team commented, "The placement of self-expanding metallic stent in Crohn's disease maintained over a period of 4 weeks is a safe, effective treatment for strictures refractory to medical treatment and/or balloon dilatation, and might be an alternative endoscopic treatment in these patients."

Aliment Pharmacol Ther 2012: 36(9): 833839
10 October 2012

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