Endoscopic dilatation for Crohn's disease has been evaluated only in some small and heterogeneous studies.
Dr Hassan and colleagues from Italy evaluated any association between the main clinical variables and endoscopic variables and the efficacy and safety of endoscopic dilatation in Crohn's disease.
|Endoscopic dilatation was technically successful in 86%|
|Alimentary Pharmacology & Therapeutics|
The team performed a Medline search regarding pneumatic dilatation in Crohn's disease.
Several technical and clinical variables were extracted from each study to build up a descriptive, pool-data analysis.
Data on individual patients were extracted from suitable studies to create a simulated population upon which a multivariate statistical analysis was performed.
The researchers found that endoscopic dilatation was mainly applied to postsurgical strictures, being technically successful in 86% of the cases.
Long-term clinical efficacy was achieved in 58% of the patients.
Mean follow-up was as long as 33 months, corresponding to 800 patient years of follow-up.
The team found that the major complication rate was 2%, being higher than 10% in 2 series.
At multivariate analysis, a stricture length of 4 cm was associated with a surgery-free outcome.
Dr Hassan's team concluded, "Endoscopic dilatation is an effective and safe treatment for short strictures caused by Crohn's disease, impacting substantially on the natural history of these patients."