Long-term outcome of endoscopic balloon dilation for small bowel strictures in patients with Crohn's disease

• Published in: Digestive endoscopy Vol. 26; no. 4; pp. 545 - 551
• Main Authors: Hirai, Fumihito, Beppu, Takahiro, Takatsu, Noritaka, Yano, Yutaka, Ninomiya, Kazeo, Ono, Yoichiro, Hisabe, Takashi, Matsui, Toshiyuki
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.07.2014
• Subjects: Adult; balloon-assisted enteroscopy; Crohn Disease - complications; Crohn's disease; Dilatation - methods; endoscopic balloon dilation; Endoscopy, Gastrointestinal - methods; Female; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - pathology; Intestinal Obstruction - therapy; Intestine, Small; Male; small bowel stricture; Treatment Outcome; Crohn's disease; endoscopic balloon dilation; small bowel stricture; balloon-assisted enteroscopy
• ISSN: 0915-5635; 1443-1661; 1443-1661
• DOI: 10.1111/den.12236

Background and Aim Endoscopic balloon dilation (EBD) is an alternative to surgery for small bowel strictures of patients with Crohn's disease (CD). However, little is known about the long‐term efficacy of EBD. The aim of the present study was to clarify the long‐term outcome of EBD for small bowel strictures in patients with CD. Methods Subjects comprised 65 patients with CD who underwent EBD for small intestinal strictures and were followed up for at least 6 months. All subjects had obstructive symptoms as a result of small bowel strictures. Short‐term success was defined as technical success and the disappearance of obstructive symptoms. The short‐term success rate of EBD, its safety profile, the cumulative surgery‐free rate and the cumulative redilation‐free rate were investigated. Results Short‐term success rate was 80.0% (52/65). Complications were encountered in six of the 65 patients (9.2%). Seventeen patients (26.2%) underwent surgery during the observation period of this study. Cumulative surgery‐free rate after initial EBD was 79% at 2 years and 73% at 3 years, respectively. EBD successful cases showed significantly higher surgery‐free rates than unsuccessful cases (P < 0.0001). In 52 of the successful cases, the cumulative redilation‐free rate after initial EBD was 64% at 2 years and 47% at 3 years, respectively. Conclusion EBD for small bowel strictures secondary to CD provides not only short‐term success but also long‐term efficacy. However, the high redilation rate is one of the clinical problems of this procedure.