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Systematic review: Endoscopic dilatation in Crohn's disease
C Hassan1, A Zullo, V De Francesco
1Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy. cesareh@hotmail.com
Alimentary Pharmacology & Therapeutics
|October 2, 2007
Summary
Endoscopic dilatation is an effective and safe treatment for short Crohn's disease strictures. Shorter strictures (< or = 4 cm) are associated with better surgery-free outcomes in Crohn's disease patients.
Area of Science:
- Gastroenterology
- Endoscopic Therapeutics
- Inflammatory Bowel Disease
Background:
- Limited data exists on endoscopic dilatation for Crohn's disease.
- Previous studies are small and heterogeneous.
Purpose of the Study:
- To assess the efficacy and safety of endoscopic dilatation in Crohn's disease.
- To identify clinical and endoscopic factors associated with treatment outcomes.
Main Methods:
- Systematic Medline search for pneumatic dilatation in Crohn's disease.
- Descriptive pooled-data analysis of technical and clinical variables.
- Multivariate statistical analysis on individual patient data from selected studies.
Main Results:
- Reviewed 13 studies with 347 Crohn's disease patients.
- Technical success rate of 86% for postsurgical strictures.
- Long-term clinical efficacy in 58% of patients; major complication rate of 2%.
- Stricture length <= 4 cm correlated with surgery-free outcome (OR: 4.01).
Conclusions:
- Endoscopic dilatation is effective and safe for short Crohn's disease strictures.
- This treatment can significantly alter the disease course for affected patients.
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