scholarly journals P730 Effectiveness and safety of endoscopic balloon dilation of colorectal strictures in Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S587-S588
Author(s):  
M TILMANT ◽  
M serrero ◽  
F Poullenot ◽  
G Bouguen ◽  
B Pariente ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Success ◽  
Balloon Dilation ◽  
Median Number ◽  
Colonic Resection ◽  
Endoscopic Balloon Dilation ◽  
Technical Success ◽  
Endoscopic Balloon

Abstract Background Endoscopic balloon dilation (EBD) is widely used to manage Crohn’s disease (CD) ileal stricture. However, data of EBD on inflammatory bowel diseases (IBD) colorectal strictures are scarce. Methods We performed a retrospective study in 9 tertiary centres, including all consecutive IBD patients who underwent EBD for native or anastomotic colorectal stricture between 1999 and 2018. Outcomes were rate of technical success defined by a passable stricture at the end of the EBD, clinical success defined by a passable and asymptomatic stricture and colonic resection at the end of follow-up. Factors associated with EBD success were also investigated by logistic regression. Results Fifty-seven patients (25 women, median age: 36 years, InterQuartile Range, 31–48) were included. All patients had CD and 42 (74%) had symptomatic stricture. Regarding the 60 strictures, 52 (87%) were native and the most frequent location was left colon (27%). 39 (65%) measured less than 5 cm, 57 (95%) were non-passable by the scope and 35 (58%) ulcerated. Among the 161 EBD performed (median number of dilatations per strictures: 1, IQR 1–3), technical success was observed in 123 (76%) EBD. One perforation occurred (0.6% per EDB and 2% per patient). After a median follow-up of 4.3 years [IQR 2.0–8.4], 24 patients (42%) underwent colonic resection, 9 (16%) had symptomatic strictures non-passable by the scope, 11 (19%) had asymptomatic non-passable strictures and 13 (23%) had asymptomatic strictures passable by the scope. One colon lymphoma and one colorectal cancer were diagnosed (3.5% of patients), respectively on endoscopic biopsies and at the time of surgery. None factor was associated with technical, clinical success, or surgery including therapeutic modification. Conclusion EBD of CD-associated colorectal strictures is feasible, efficient and safe as more than 50% of patients avoid surgery.

scholarly journals P650 Outcomes of endoscopic balloon dilation for luminal strictures in Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S535-S536
Author(s):  
R Sarraj ◽  
M Martinho ◽  
F Bravo ◽  
E Benz ◽  
P Juillerat
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Success Rate ◽  
Balloon Dilation ◽  
University Hospital ◽  
Endoscopic Balloon Dilation ◽  
Short Term ◽  
Anastomotic Strictures ◽  
Endoscopic Balloon

Abstract Background Luminal strictures are common complications of Crohn’s disease (CD). Endoscopic balloon dilation (EBD) is an alternative to surgery for CD strictures. (1–3). The aim of this study was to evaluate the EBD success rate and identify predictive factors in CD patients. Methods 27 consecutive patients with CD in whom EBD was performed at the outpatient clinic of Bern University Hospital were retrospectively included in this study. Clinical, laboratory and endoscopic data were collected from the patient files. Stricture characteristics, short-term procedure success, procedure-related complications, occurrence of surgery and long-term clinical endpoints were documented. Short-term procedure success was defined by the ability to pass an 11.5-mm-wide endoscope through the stricture after dilatation and the absence of any documented complications during a 1-week follow-up. Results The study population consisted of 27 patients with Crohn’s disease. A total of 41 dilations were performed. 61.5% of the patients were on biologic therapy. The short-term dilatation success rate was 60%. 48.1% of the patients required stricture related surgery during the follow-up. There were two procedure-related complications 0.08% (bleeding; asymptomatic perforation discovered during surgery). 33.3% were anastomotic strictures. The median increase in dilatation diameter during a single session was 6 mm (range, 3–12mm). 53.8% of the patients required multiple dilatations during the same endoscopic procedure. In the Kaplan–Meier log-rank analysis, anastomotic strictures (secondary) did show a trend toward a longer surgery-free survival after EBD (p = 0.057) (Figure1) Conclusion EBD is successful and safe in treating luminal strictures and in prevention of immediate surgery in a high proportion of CD patients, in particular for anastomotic stricture. References

Crohn's Disease Obstructions

2021 ◽  
Vol 34 (04) ◽  
pp. 227-232
Author(s):  
Molly M. Ford
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Acute Inflammation ◽  
Balloon Dilation ◽  
Additional Treatment ◽  
Endoscopic Balloon Dilation ◽  
Endoscopic Balloon

AbstractObstruction from stricturing Crohn's disease remains one of the most common reasons for intervention. Acute inflammation is often responsive to medications, but chronic fibrosis is unlikely to respond and will generally go on to require additional treatment. Newer methods, such as endoscopic balloon dilation, are gaining grounds in strictures that are amenable, but with high recurrence and strictures that may not be endoscopically accessible, surgery still plays a key role in the treatment of obstructing Crohn's disease.

scholarly journals Repeated endoscopic balloon dilation for an ileocecal stricture with an internal fistula for a patient with Crohn's disease

2019 ◽  
Vol 95 (1) ◽  
pp. 72-74
Author(s):  
Yusuke Sakurai ◽  
Hirotsugu Sakamoto ◽  
Tomonori Yano ◽  
Keijiro Sunada ◽  
Hironori Yamamoto
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Balloon Dilation ◽  
Endoscopic Balloon Dilation ◽  
Internal Fistula ◽  
Endoscopic Balloon

W1113 Efficacy and Safety of Endoscopic Balloon Dilation of Symptomatic Intestinal Crohn's Disease Strictures

2009 ◽  
Vol 136 (5) ◽  
pp. A-656-A-657
Author(s):  
Daniela Scimeca ◽  
Filippo Mocciaro ◽  
Ambrogio Orlando ◽  
Luigi M. Montalbano ◽  
Gennaro D'Amico ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Balloon Dilation ◽  
Efficacy And Safety ◽  
Endoscopic Balloon Dilation ◽  
Endoscopic Balloon

scholarly journals Endoscopic Balloon Dilation of Intestinal Strictures in Crohn's Disease

2011 ◽  
Vol 140 (5) ◽  
pp. S-140
Author(s):  
Anders Gustavsson ◽  
Anders Magnuson ◽  
Björn Blomberg ◽  
Magnus Andersson ◽  
Jonas Halfvarson ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Balloon Dilation ◽  
Endoscopic Balloon Dilation ◽  
Endoscopic Balloon

The Role of Immunomodulators and Biologics in the Medical Management of Stricturing Crohn’s Disease

2019 ◽  
Vol 14 (4) ◽  
pp. 557-566 ◽  
Author(s):  
Iago Rodríguez-Lago ◽  
Javier P Gisbert
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Balloon Dilation ◽  
Endoscopic Balloon Dilation ◽  
Inflammatory Lesions ◽  
Prevention And Treatment ◽  
Inflammatory Changes ◽  
Endoscopic Balloon

Abstract Crohn’s disease is a progressive and disabling inflammatory disease involving the gastrointestinal tract. It usually produces inflammatory lesions in the ileocolonic region, but up to half of patients will also develop complications such as strictures in the long term. Indeed, a proportion of patients have progression of the disease with the development of stricturing lesions because there are no drugs that effectively prevent or reverse established fibrosis, and hence these patients are usually treated with surgery or endoscopic balloon dilation. Fibrotic lesions are always associated with some degree of inflammatory changes, but there is little evidence supporting the use of medical therapy in this context. Here, we discuss the most important findings on the possible use of immunomodulators or biologics in the prevention and treatment of intestinal strictures in Crohn’s disease patients. Recent evidence demonstrates that these drugs may also be effective in treating lesions with high levels of collagen deposition, and thus might, at least in some patients, reduce the progression of the disease and bowel damage, and further avoid the need for surgery and a disabling course in the long term.

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