Efficacy and safety of endoscopic balloon dilation in inflammatory bowel disease: results of the large multicenter study of the ENEIDA registry

Andújar, Xavier; Loras, Carme; González, Begoña; Socarrás, M.E. Rodríguez; Sanchiz,; Boscá, M; Domènech, Eugeni; Calafat, Margalida; Rodríguez, Esther; Sicilia, Beatriz; Calvet, Xavier; Barrio, Jesús; Guardiola, Jordi; Iglesias, Eva; Casanova, M J; Y, Ber; Monfort, David; López-Sanromán, Antonio; Rodríguez‐Lago, Iago; Bujanda, Luís; Márquez, Lucía; Martín-Arranz,; Zabana, Yamile; Fernández‐Bañares, Fernando

doi:10.1007/s00464-019-06858-z

Cited by 26 publications

(21 citation statements)

References 27 publications

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“…Andujar et al . found similarly that not receiving anti‐TNF at the time of dilation was associated with avoidance of surgery or repeat dilation (OR 1.7; 95% CI 1.1–2.6) 48 …”

Section: Resultsmentioning

confidence: 84%

“…in a study of EBD for de novo (primary) strictures reported an HR of 2.0 for every 1‐cm increment in stricture length (2.0 95% CI 1.3–3.3). Andujar et al 48 . in another recent study found stricture length (≤ 2 cm) to be independently associated with therapeutic success on multivariate regression analysis (HR 2.43; 95% CI 1.1–5.3).…”

Section: Resultsmentioning

confidence: 93%

“…Multiple studies have compared outcomes of EBD for anastomotic versus de novo strictures. In the majority of studies, there was no difference in therapeutic outcomes 48,67,70,77,91,98 …”

Section: Resultsmentioning

confidence: 99%

“…Three studies incorporated the use of stents to treat Crohn's disease strictures in a largely treatment refractory cohort. In a large cohort of 187 patients who underwent EBD by Andujar et al ., 48 11 patients had “rescue” endoscopic stent placement after failure of EBD. Of these, seven (64%) avoided surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Multiple predictors of treatment success were identified from the 60 endoscopic therapy studies. The most consistent predictor of treatment success was stricture length 22,47,48,52,58 . However, few studies included patients with strictures longer than 5 cm.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of drug and endoscopic treatment of Crohn's disease strictures: A systematic review

Schulberg

Wright

Holt

et al. 2020

J of Gastro and Hepatol

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Background and Aims Strictures are the commonest complication in Crohn's disease. Surgery and endoscopic dilation are the mainstays of treatment, while drug therapy has often been considered contraindicated. The benefit of nonsurgical treatments, particularly drug and endoscopic therapy, need to be defined. Methods Ovid MEDLINE, Embase, Emcare, PsycINFO, CINAHL and the Cochrane Library (inception until August 30, 2019) were searched. Studies with ≥ 10 patients with Crohn's disease strictures, reporting on outcomes following medication or endoscopic treatment, were included. Results Of 3480 records, 85 studies met inclusion criteria and formed the basis of this analysis. Twenty‐five studies assessed drug therapy; none were randomized trials. Despite study heterogeneity anti‐tumor necrosis factor (TNF) therapy appeared effective, with 50% of patients avoiding surgery after 4 years of follow up. No other drug therapy was of demonstrable benefit. Sixty studies assessed endoscopic therapy including 56 on endoscopic balloon dilation, two assessed needle knife stricturotomy, and two stent insertion. Dilation was equally effective for de novo and anastomotic strictures ≤ 5 cm in length, with most studies reporting a subsequent surgical rate of 30% to 50%. Repeat dilation was required in approximately half of all patients. Conclusions Anti‐TNF drug therapy and endoscopic balloon dilation are effective strategies for avoiding surgery in patients with stricturing Crohn's disease. Additional endoscopic therapies require further evaluation. Early data suggest that combining these therapies may provide greater benefit than individual therapies. Optimization of current drug and endoscopic therapy, and the incorporation of newer therapies, are needed for stricturing Crohn's disease.

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“…Andujar et al . found similarly that not receiving anti‐TNF at the time of dilation was associated with avoidance of surgery or repeat dilation (OR 1.7; 95% CI 1.1–2.6) 48 …”

Section: Resultsmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 93%

“…Multiple studies have compared outcomes of EBD for anastomotic versus de novo strictures. In the majority of studies, there was no difference in therapeutic outcomes 48,67,70,77,91,98 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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