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 22 February 2018

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News

Endoscopic balloon dilation safe for treating Crohn's strictures

May's issue of Endoscopy shows that endoscopic balloon dilation is a safe and effective method that allows surgery to be avoided in about 75% of patients with Crohn's-associated short intestinal strictures.

News image

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Strictures are a substantial cause of morbidity in patients with Crohn's disease.

Endoscopic balloon dilation is a therapeutic option in limited strictures to avoid intestinal surgery.

However, there have been few reports regarding the long-term outcome.

Dr Ferlitsch and colleagues from Austria scheduled balloon dilation in 46 patients.

Of these patients, 26 were women, and 20 were men with a median age of 34.

The patients had Crohn's-associated symptomatic and radiographically confirmed intestinal stenosis.

The investigative team envisaged up to 4 consecutive treatments within the first 2 months until relief of symptoms.

Thereafter, the team planned dilations depending on clinical requirements.

Dilation was not possible in 7 of the patients, due to technical problems, internal fistulas, or absence of a stenosis.

Cumulative percentages of patients without a repeat surgery at 6 months was 97%
Endoscopy

The investigators reported that 39 patients received at least 1 treatment.

The site of obstruction was ileocolonic anastomosis in 23 of the 39 patients, and surgically untreated areas in 16 patients.

After the initial dilation series, the team traversed strictures in 37 of the 39 patients.

During a median follow-up period of 21 months, 24 of the 39 patients underwent a repeat intervention.

The investigators noted that 12 underwent with repeat dilation, 11 had surgical resection, and 1 patient received an intestinal stent.

The cumulative percentages of patients without a repeat intervention at 6, 12, 24, and 36 months were 68%, 48%, 36%, and 31%, respectively.

The team also found that the cumulative percentages of patients without a repeat surgery at 6, 12, 24, and 36 months were 97%, 91%, 84% and 75%, respectively.

In addition, 2 perforations, and 1 case of severe bleeding were seen in the 73 dilation procedures performed.

Dr Ferlitsch's team commented, “Endoscopic balloon dilation is a safe and effective method that allows surgery to be avoided in approximately 75% of patients with Crohn's-associated short intestinal strictures.”

“However, recurrent symptoms frequently make it necessary to repeat the procedure.”

Endoscopy 2006: 38: 483-7
15 May 2006

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