Endoscopic balloon dilatation of Crohnʼs Disease strictures
Bhalme, M, Sarkar, S, Lal, S, Bodger, K, Baker, RD and Willert, RP 2014, 'Endoscopic balloon dilatation of Crohnʼs Disease strictures' , Inflammatory Bowel Diseases, 20 (2) , pp. 265-270.
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Introduction: Stricturing is a common complication of Crohn's disease. Endoscopic balloon dilatation (EBD) offers a valuable alternative to surgical intervention, but there are limited data on factors influencing its safety and efficacy. Methods: A multicenter retrospective audit across 4 U.K. teaching hospitals was performed on the use of EBD for Crohn's strictures between 1998 and 2011. Demographics, smoking status, medications, C-reactive protein, endoscopic findings, and subsequent surgery at follow-up were recorded. Success of EBD was defined as symptomatic improvement without the need for surgery at follow-up. Results: Seventy-nine patients (47 women; median age, 48 yr) were identified for this study. Forty-eight (61%) patients had ileocolonic anastomotic strictures, whereas the rest had de novo strictures. In total, 191 EBDs (range, 1-11; median 2) were carried out on 93 strictures (range, 1-5; median 1) over a median duration of 12 months (range, 1-84). There were no serious adverse events. Success at index EBD was 34%, with a further 43% achieving long-term benefit from additional EBDs. Eighteen (23%) patients required surgery. Time to surgery after the first EDB was 2.6 to 71.1 months (median, 12.8 mo). Longer Crohn's disease duration (P = 0.03) and high C-reactive protein (P = 0.008) were associated with an increased need for subsequent surgery. Conclusions: EBD was safe and effective in achieving long-term symptom improvement and avoidance of surgery in most patients. Prospective controlled trials are needed to evaluate the effect of other factors, including Crohn's disease phenotype, and the role of concomitant medication to identify those best suited to EBD.
|Schools:||Schools > Salford Business School
Schools > Salford Business School > Salford Business School Research Centre
|Journal or Publication Title:||Inflammatory Bowel Diseases|
|Funders:||Non funded research|
|Depositing User:||S Rafiq|
|Date Deposited:||21 Mar 2014 17:54|
|Last Modified:||08 Nov 2015 23:04|
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