Colonoscopic balloon dilation of Crohnʼs strictures

Thomas-Gibson, Siwan; Brooker, Jim C.; Hayward, Christopher MM; Shah, Syed G.; Williams, Christopher; Saunders, Brian P.

doi:10.1097/01.meg.0000059110.41030.bc

Cited by 43 publications

(5 citation statements)

References 14 publications

(21 reference statements)

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“…They suggested that primary strictures might be treated in the same way as anastomotic strictures. Recently, Thomas-Gibson et al 12 reported on a large series of cases (59 patients), describing a long-term clinical benefit of 41 percent (at a mean follow-up of 29 months) with two perforations. In our study, the cumulative nonsurgical rates for the dilation strictures were 93 percent at 12 months, 65 percent at 36 months, 81 percent at 12 months, and 46 percent at 36 months, including lesions that were not related to the dilation location.…”

Section: Discussionmentioning

confidence: 97%

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Efficacy and Safety of Endoscopic Balloon Dilation for Crohn's Strictures

Nomura

Takagi

Kikuchi

et al. 2006

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 97%

“…[3][4][5][6][7][8] However, there are few data concerning the long-term results of this treatment for Crohn_s strictures. [9][10][11][12] We investigated the safety and long-term efficacy of endoscopic hydrostatic balloon dilation for intestinal strictures in Crohn_s disease in a retrospective series.…”

mentioning

confidence: 99%

Efficacy and Safety of Endoscopic Balloon Dilation for Crohn's Strictures

Nomura

Takagi

Kikuchi

et al. 2006

Diseases of the Colon &Amp; Rectum

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“…Technical success was achieved in all patients (n = 37). Repeat dilation was required in 40.5% (n = 15) of patients (long-term efficacy: 59.5%), with a median balloon dilation of 16.5mm (range [10][11][12][13][14][15][16][17][18]. Technical success and improvement in obstructive symptoms were achieved in all patients without AEs.…”

Section: Non-anastomotic Stricturesmentioning

confidence: 95%

“…During long-term follow-up patients needing surgery at 1, 3 and 5 years varies form 13%-17%, 28%-42%, and 36%-42% respectively. Strictures recur following dilation, and re-dilation may be required in up to 20% and 50% by 1 and 5 years, respectively [1,14,15] . The best results following dilation are obtained when stricture length is < 4 cm, and for anastomotic strictures when compared to de novo strictures [1,12,16] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Balloon Dilation of Crohnʼs Disease Strictures: Safety, Efficacy and Clinical Impact

Lopes

Andrade

Rodrigues

et al. 2017

American Journal of Gastroenterology

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AIMTo evaluate the incidence of anastomotic strictures after intestinal resection in Crohn's disease (CD), demonstrate long-term efficacy and safety of endoscopic balloon dilation (EBD) in CD strictures and its impact on the diagnosis of subclinical postoperative endoscopic recurrence. METHODSRetrospective single tertiary center study based on prospectively collected data between 2010 and 2015 7397November 7, 2017|Volume 23|Issue 41| (online)including anastomotic and non-anastomotic strictures. RESULTS29% of 162 CD patients included developed an anastomotic stricture. 43 patients with anastomotic strictures and 37 with non-anastomotic strictures underwent EBD; technical success was 97.7% and 100%, respectively, however, 63% and 41% needed repeat dilation during the 4.4-year follow-up. Longer periods between surgery and index colonoscopy and higher lactoferrin levels were associated with the presence of stricture after surgery. Calprotectin levels > 83.35 µg/g and current or past history of smoking were associated with a shorter time until need for dilation (HR = 3.877, 95%CI: 1.480-10.152 and HR = 3.041, 95%CI: 1.213-7.627). Anastomotic strictures had a greater need for repeat dilation (63% vs 41%, P = 0.047). No differences were found between asymptomatic and symptomatic cohorts. Disease recurrence diagnosis was only possible after EBD in a third of patients. CONCLUSIONEBD is an effective and safe alternative to surgery, with a good short and long-term outcome, postponing or even avoiding further surgery. EBD may allow to diagnose disease recurrence in patients with no clinical signs/biomarkers of disease activity.

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“…For these strictures, ELS can offer a minimally invasive alternative to surgery[ 126 ]. Among the different available stent types, FCSEMSs and PCSEMSs were used for this indication[ 128 , 129 ]. Preliminary experience has shown conflicting results with several studies reporting different clinical success rates that range between 36% to 100%.…”

Section: Common Applications and Complications Of Elsmentioning

confidence: 99%

Endoscopic luminal stenting: Current applications and future perspectives

Moutzoukis¹,

Argyriou²,

Kapsoritakis³

et al. 2023

World J Gastrointest Endosc

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Endoscopic luminal stenting (ELS) represents a minimally invasive option for the management of malignant obstruction along the gastrointestinal tract. Previous studies have shown that ELS can provide rapid relief of symptoms related to esophageal, gastric, small intestinal, colorectal, biliary, and pancreatic neoplastic strictures without compromising cancer patients’ overall safety. As a result, in both palliative and neoadjuvant settings, ELS has largely surpassed radiotherapy and surgery as a first-line treatment modality. Following the abovementioned success, the indications for ELS have gradually expanded. To date, ELS is widely used in clinical practice by well-trained endoscopists in managing a wide variety of diseases and complications, such as relieving non-neoplastic obstructions, sealing iatrogenic and non-iatrogenic perforations, closing fistulae and treating post-sphincterotomy bleeding. The abovementioned development would not have been achieved without corresponding advances and innovations in stent technology. However, the technological landscape changes rapidly, making clinicians’ adaptation to new technologies a real challenge. In our mini-review article, by systematically reviewing the relevant literature, we discuss current developments in ELS with regard to stent design, accessories, techniques, and applications, expanding the research basis that was set by previous studies and highlighting areas that need to be further investigated.

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Colonoscopic balloon dilation of Crohnʼs strictures

Abstract: Colonoscopic balloon dilation of Crohn's strictures can achieve long-term clinical benefit in many patients. Repeat dilations are justified in initial non-responders. In this series, the procedure appears safe with low morbidity.

Cited by 43 publications

References 14 publications

Efficacy and Safety of Endoscopic Balloon Dilation for Crohn's Strictures

Efficacy and Safety of Endoscopic Balloon Dilation for Crohn's Strictures

Endoscopic Balloon Dilation of Crohnʼs Disease Strictures: Safety, Efficacy and Clinical Impact

Endoscopic luminal stenting: Current applications and future perspectives

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