Long-term outcome of endoscopic pneumatic dilatation in Crohn's disease

Morini, Sergio; Hassan, Cesare; Lorenzetti, Roberto; Zullo, Angelo; Winn, Simon; Cerro, Paola

doi:10.1016/s0016-5085(03)83182-7

Cited by 16 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At the moment, it is difficult to define the relapse risk after endoscopic balloon dilatation, as the published studies [8,[17][18][19] are based on very different follow-up periods, and often do not represent structured prospective longterm studies.…”

Section: Discussionmentioning

confidence: 99%

“…Valid long-term studies of 5 years or more, which would permit a statement regarding recurrence of strictures and a better comparison with surgical techniques [3,4] , are available so far only in casuistic form and with limited numbers [8,[17][18][19] . We report on our own prospective 10-year long-term study of endoscopic balloon dilatation of strictures in Crohn's disease using a relatively thin balloon (18 mm) and additional treatment with prednisolone.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Stienecker¹,

Gleichmann²,

Neumayer³

et al. 2009

WJG

View full text Add to dashboard Cite

AIM:To examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. METHODS:A total of 25 patients (20 female and five male: aged 18-75 years), with at least one symptom of stricture not passable with the standard colonoscope and with a confirmed scarred Crohn's stricture of the lower gastrointestinal tract, were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Stienecker¹,

Gleichmann²,

Neumayer³

et al. 2009

WJG

View full text Add to dashboard Cite

show abstract

“…At 1 year Sabate et al 7 reported only a 64% symptom-free success rate, while at a mean of 29 months Thomas-Gibson et al 9 reported only 41% of patients free of symptoms. Morini et al 6 reported that at Ϸ64 months 52.9% of patients had avoided symptomatic recurrence, but this number excludes 9 of the original 43 patients in that study who were technical failures. On an "intent to treat" basis, their success rate falls to 42%.…”

Section: Summary Of Technique and Outcomesmentioning

confidence: 92%

“…Although Singh et al 11 reported a 10% complication rate, this is based on number of dilatations performed 29 , when in fact their 3 complications were in 17 patients, for a more clinically relevant complication rate of 18%. Morini et al 6 reported no serious complications in 34 successfully dilated patients. However, that group used only 18-mm balloons, performed an average of 3 separate dilatation sessions per patient, and 9 of their original 43 patients were unable to be dilated using their more cautious approach.…”

Section: Complications Of Endoscopic Balloon Dilatationmentioning

confidence: 94%

See 1 more Smart Citation

Dangers associated with endoscopic management of strictures in IBD

Koltun

2007

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

A clear cause and cure for Crohn's disease (CD) continues to elude caregivers and researchers alike, much to the frustration of these frequently youthful and usually very symptomatic patients. The experienced clinician recognizes that he or she is frequently treating only the complications of CD and not the disease itself. Thus, drugs are used to quell mucosal inflammation and to treat foci of sepsis (fistuli and abscesses) without knowing what is actually causing the inflammation or abscesses.One of the most symptomatic of CD complications is intestinal obstruction brought about by either severe inflammation compromising the lumen of the bowel or a fibrotic stricture, the result of "burnt out" inflammation and scarring. Such bowel obstruction can present as an acute emergency but more often is manifest as recurrent, crampy abdominal pain aggravated by oral intake, especially of high-fiber foods. Twenty percent of CD patients will have small bowel strictures, usually near the terminal ileum, while about another 10% will have colonic strictures. 1 Such symptomatic strictures, when inflammatory, should be treated with appropriate antiinflammatory medications. When nonresponsive to medical management or when fixed and fibrotic, surgical resection and anastomosis can provide dramatic relief, especially in the case of ileocolic disease. However, such surgery will commonly be followed by recurrence of disease, initially inflammatory, subsequently fibrotic, precipitating the need for recurrent surgery in Ϸ50% of patients at 10 years. 2-4 Such recurrence is more a failure of effective medical management than it is of surgery. Regardless, this repetitive cycle of relapsing inflammation, stricturing, and the need for surgical resection can potentially result in short gut with the associated cumulative risk of numerous surgical procedures. In this context the concept of a nonsurgical endoscopic technique to relieve the obstructive symptoms of intestinal stricturing has intuitive appeal. Unfortunately, this attractive first impression must be tempered with some of the realistic problems associated with the technique. SUMMARY OF TECHNIQUE AND OUTCOMESThe technique of endoscopic balloon dilatation is widely variable, based largely on the preference and experience of the endoscopist. 5 Obviously, the stricture must be reachable, so most are either colonic or ileocolic and not infrequently an anastomotic stricture after previous operative ileocolectomy. Some clinicians dilate using balloon diameters to as large at 25 mm 3 , but most will dilate only to 18 or 20 mm, citing a lower complication rate. Insufflation is usually held for several (1-4) minutes, and then the balloon is deflated and the process repeated several times until an adequate lumen is appreciated visually. Sometimes successful dilatation is defined by the subsequent passage of the colonoscope (about 13 mm in diameter) through the stricture, but this is inconsistent in the literature and not necessarily associated with a higher symptomatic relief rate. Frequently,...

show abstract

Outcomes for overlapping stents in the extracranial carotid artery

Lesley

Weigele

Chaloupka

2004

Cathet Cardio Intervent

View full text Add to dashboard Cite

Various diseases of the carotid artery are treatable by stenting. However, few reports of overlapping carotid stents exist. As a result, the indications, long-term outcomes, and potential complications of this technique remain largely unknown. We therefore present and examine a series of 11 patients treated by this unique stenting method. A retrospective single-institution review was performed for patients in whom overlapping carotid stents were placed. Only patients with imaging follow-up beyond 3 months were included. Of 38 patients who had extracranial carotid artery stents placed, 11 patients fulfilled the inclusion criteria for both overlapping stents and imaging follow-up greater than 3 months (range, 0.4-3 years; mean, 1.3 years). Clinical follow-up ranged between 0.4 and 3.6 years (mean, 2.1 years). Carotid pathology within this cohort included atheromatous stenosis (n = 3), recurrent stenosis following carotid endarterectomy (n = 2) or stenting (n = 1), postirradiation angiitis (n = 1), carotid artery kink created by initial stent placement (n = 2), and both traumatic (n = 1) and neoplastic (n = 1) carotid blowout syndrome. No permanent stroke or stenting-related death occurred. Focal stenosis or intimal hyperplasia resulting in 35% or less luminal narrowing developed in three patients (27%) after tandem stenting. Overlapping stents provide a durable treatment for a variety of extracranial carotid pathologies. Clinically and hemodynamically significant (> 50%) poststenting stenosis or intimal hyperplasia did not occur in this series.

show abstract

Long-term outcome of endoscopic pneumatic dilatation in Crohn's disease

Cited by 16 publications

References 0 publications

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Dangers associated with endoscopic management of strictures in IBD

Outcomes for overlapping stents in the extracranial carotid artery

Contact Info

Product

Resources

About