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Endoscopic balloon dilation for stenotic lesions in Crohn's disease
Akira Kanamori1, Takeshi Sugaya, Keiichi Tominaga
1Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan. t-sugaya@dokkyomed.ac.jp.
Insights
Endoscopic balloon dilation (EBD) offers a safe and effective alternative to surgery for Crohn's disease (CD) patients with intestinal stenosis, showing high success rates and favorable outcomes.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Inflammatory bowel disease
Background:
- Crohn's disease (CD) frequently causes intestinal stenosis, a condition often treated surgically.
- Endoscopic balloon dilation (EBD) presents a less invasive alternative, but its efficacy and safety remain debated.
- Evaluating EBD's role in managing CD-related intestinal strictures is crucial for optimizing patient care.
Purpose of the Study:
- To assess the therapeutic efficacy and safety of Endoscopic Balloon Dilation (EBD) for intestinal stenosis in Crohn's disease (CD) patients.
- To determine the scope passage rate, surgery-free rate, and the influence of distal intestinal tract observation on treatment strategy.
- To evaluate the long-term outcomes and safety profile of EBD in this patient population.
Main Methods:
- Retrospective analysis of 30 Crohn's disease patients who underwent Endoscopic Balloon Dilation (EBD) for intestinal stenosis.
- Assessment of key outcomes including scope passage rate and surgery-free rate.
- Evaluation of the impact of observing the distal intestinal tract on therapeutic strategy decisions.
Main Results:
- High overall scope passage (90.0%) and surgery-free (76.7%) rates were observed.
- No significant differences in dilation site were noted across patient groups.
- A 46.7% re-dilation rate was recorded, with a mean time to re-dilation of 6.6 months; 56.7% showed distal inflammation post-EBD.
Conclusions:
- Endoscopic Balloon Dilation (EBD) demonstrates favorable short- and long-term outcomes and good safety for treating intestinal stenosis in Crohn's disease.
- EBD can effectively postpone or avoid surgery, facilitating both dilation and mucosal healing assessment.
- Observation of the distal intestinal tract influences therapeutic strategy, supporting EBD as a viable alternative treatment.
Background/Aims:
Endoscopic balloon dilation (EBD) can serve as an alternative to surgery for intestinal stenosis associated with Crohn's disease (CD). However, there has been controversy regarding the efficacy and safety of EBD. Here we sought to determine the therapeutic efficacy and safety of EBD for intestinal stenosis in CD.
Materials And Methods:
Of 43 patients with CD accompanied by intestinal stenosis, 30 underwent EBD. These 30 patients were examined retrospectively in terms of the scope passage rate, surgery-free rate, and whether or not the observation of the distal intestinal tract influenced the therapeutic strategy.
Results:
The overall scope passage and surgery-free rates were 90.0% and 76.7%, respectively. There were no statistically significant differences in the site of the dilated intestinal tract among groups. Patients who had inflammation in the distal intestinal tract alone after EBD accounted for 56.7%. The rate of re-dilation was 46.7%, and time until re-dilation was 6.6±3.6 months.
Conclusion:
EBD was associated with favorable short-term and long-term outcomes and good safety. Observation of the distal intestinal tract influenced the decision-making process for therapeutic strategies. The results of this study suggest that EBD may allow the postponement or even avoidance of surgery, enabling not only intestinal dilation but also the evaluation of mucosal healing to be performed. Thus, EBD is considered to be an effective alternative treatment for intestinal stenotic lesions in patients with CD.
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