Endoscopic dilatation of Crohn's disease-related strictures is an alternative to surgical resection in selected patients.
The influence of disease activity and concomitant medical therapy on long-term outcomes is largely unknown.
Dr Van Assche and colleagues from Belgium studied the long-term safety and efficacy of stricture dilatation in a single centre cohort.
The researchers found that between 1995 and 2006, 237 dilatations where performed in 138 patients for a clinically obstructive stricture.
|Recurrent obstructive symptoms led to a new dilatation in 46%|
Immediate success of a first dilatation was 97% with a 5% serious complication rate.
After a median follow-up of 6 years, recurrent obstructive symptoms led to a new dilatation in 46% or surgery in 24%.
Niether elevated levels of C-reactive protein nor endoscopic disease activity predicted the need for new intervention.
None of the concomitant therapies influenced the outcome.
Dr Van Assche's team concluded, “This largest series ever reported confirms that long term efficacy of endoscopic dilatation of Crohn's disease outweighs the complication risk.”
“Neither active disease at the time of dilatation nor medical therapy afterwards predict recurrent dilatation or surgery.”