Safety and efficacy of endoscopic balloon dilation for treatment of Crohn's disease strictures.

Ferlitsch, A, Reinisch, W, Püspök, A, Dejaco, C, Schillinger, M, Schöfl, R, Pötzi, R, Gangl, A and Vogelsang, H (2006) Safety and efficacy of endoscopic balloon dilation for treatment of Crohn's disease strictures. Endoscopy, 38 (5). pp. 483-7. ISSN 0013-726X

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BACKGROUND AND STUDY AIMS Strictures are a substantial cause of morbidity in patients with Crohn's disease. Endoscopic balloon dilation is a therapeutic option in limited strictures to avoid intestinal surgery, although there have been few reports regarding the long-term outcome. PATIENTS AND METHODS Balloon dilation was scheduled for 46 patients (26 women, 20 men; median age 34) with Crohn's-associated symptomatic and radiographically confirmed intestinal stenosis. The study plan envisaged up to four consecutive treatments within the first 2 months until relief of symptoms, and thereafter dilations depending on clinical requirements. RESULTS Dilation was not possible in seven of the 46 patients (15 %), due to technical problems (n = 2), internal fistulas (n = 3), or absence of a stenosis (n = 2). Thirty-nine patients received at least one treatment. The site of obstruction was the ileocolonic anastomosis in 23 of the 39 patients (59 %) and surgically untreated areas in 16 patients (41 %). After the initial dilation series (median 1, interquartile range 1-2), strictures were traversed in 37 of the 39 patients (95 %). During a median follow-up period of 21 months (range 3-98 months), 24 of the 39 patients (62 %) underwent a repeat intervention, including 12 (31 %) with repeat dilation, 11 (28 %) with surgical resection, and one patient who received an intestinal stent. The cumulative percentages of patients without a repeat intervention or surgery at 6, 12, 24, and 36 months were 68 %, 48 %, 36 %, and 31 %, and 97 %, 91 %, 84 % and 75 %, respectively. Two perforations and one case of severe bleeding were seen in the 73 dilation procedures (4 %) performed. CONCLUSIONS Endoscopic balloon dilation is a safe and effective method that allows surgery to be avoided in approximately 75 % of patients with Crohn's-associated short intestinal strictures. However, recurrent symptoms frequently make it necessary to repeat the procedure.
Item Type: Article
Divisions: Ordensklinikum Linz Barmherzige Schwestern > Interne IV: Gastroenterologie & Hepatologie, Endokrinologie und Stoffwechsel, Ernährungsmedizin
Depositing User: Prof. Dr. Rainer Schöfl
Date Deposited: 16 Nov 2021 11:40
Last Modified: 16 Nov 2021 11:40

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