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Endoscopic balloon dilation of colorectal strictures complicating Crohn's disease: a multicenter study

Marion Tilmant1, Mélanie Serrero2, Florian Poullenot3

  • 1Department of Gastroenterology, Amiens University Hospital, Amiens, France.

Clinics and Research in Hepatology and Gastroenterology
|November 20, 2020
PubMed

Insights

Endoscopic balloon dilation (EBD) for colorectal strictures in Crohn's disease (CD) is safe and effective. Over 40% of patients achieved remission without surgery, highlighting EBD as a viable treatment option.

Area of Science:

  • Gastroenterology
  • Endoscopic procedures
  • Inflammatory bowel disease

Background:

  • Endoscopic balloon dilation (EBD) is established for ileal strictures in Crohn's disease (CD).
  • EBD for colorectal strictures in CD is less understood.
  • Colorectal strictures are a significant complication in CD management.

Purpose of the Study:

  • To evaluate the efficacy and safety of EBD for colorectal strictures in CD patients.
  • To identify factors associated with EBD failure in CD-related colorectal strictures.
  • To assess long-term outcomes following EBD for colorectal strictures.

Main Methods:

  • Retrospective multicenter study of CD patients undergoing EBD for colorectal strictures (1999-2018).
  • Logistic regression analysis to identify factors associated with EBD failure.
  • Data collected on stricture characteristics, EBD procedures, success rates, complications, and long-term outcomes.

Main Results:

  • 60 colorectal strictures in 57 CD patients were treated with 161 EBDs.
  • Technical and clinical success rates were 79% and 77%, respectively.
  • 42% of patients were asymptomatic without surgery after a median follow-up of 4.3 years; 42% required colonic resection. One perforation (0.6%) occurred. No factors predicted success.

Conclusions:

  • EBD is a feasible, effective, and safe treatment for CD-associated colorectal strictures.
  • Over 40% of patients achieve long-term remission without surgical intervention.
  • EBD offers a valuable non-surgical option for managing colorectal strictures in Crohn's disease.
Abstract

Keywords:
Crohn’s diseasecolonic stricturesendoscopic balloon dilatation

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