Hydrostatic balloon dilatation of Crohn's strictures

Area of Science:

• Gastroenterology
• Endoscopic Therapeutics
• Inflammatory Bowel Disease

Background:

• Crohn's disease frequently causes intestinal strictures, leading to obstructive symptoms and impacting quality of life.
• Surgical intervention for strictures carries risks and may not always be the optimal long-term solution.

Purpose of the Study:

• To assess the safety and long-term effectiveness of per-endoscopic hydrostatic balloon dilatation for managing symptomatic strictures in Crohn's disease patients.
• To evaluate the recurrence rates of obstructive symptoms and the need for subsequent surgery after dilatation.

Main Methods:

• A retrospective analysis of 38 patients with Crohn's disease who underwent balloon dilatation for intestinal strictures.
• Strictures were located in various segments including ileo-colonic/colocolic anastomoses, colon, ileum, jejunum, and ileo-caecal valve.

Main Results:

• Successful dilatation was achieved in 32 out of 38 patients, with a median follow-up of 22.8 months.
• Probabilities of obstructive symptom recurrence were 36% at 1 year and 60% at 5 years; surgical probabilities were 26% at 1 year and 43% at 5 years.
• Complications occurred in 9.4% of sessions, with a single perforation, and results were not affected by patient demographics or disease activity.

Conclusions:

• Per-endoscopic hydrostatic balloon dilatation is an effective endoscopic treatment for symptomatic Crohn's disease strictures.
• This procedure can help avoid or postpone surgery, offering a viable therapeutic option with a manageable safety profile.