Effectiveness and safety of endoscopic balloon dilatation for strictures in Crohn's disease – a multicenter study

Introduction: Crohn's disease (CD) is a chronic inflammatory disease which frequently complicated by obstructive symptoms secondary to development of intestinal strictures. The aim of this study was to assess effectiveness, safety of endoscopic balloon dilatation.

Patients and methods: Data of 90 endoscopic balloon dilations in 44 CD patients were retrospectively analyzed. 13.3% of procedures were performed in upper gastrointestinal (GI) tract and 86.7% in lower GI tract. 10 – 18 mm diameter sized balloons were used. Short-term success rate was defined as the ability of endoscope to traverse the stenosis after dilatation. Long-term clinical success rate was claimed if a patient remained asymptomatic and did not require surgery or further endoscopic dilation, following technical success.

Results: 62.2% of strictures were de novo and 37.8% anastomotic. The mean time between diagnosis and development of strictures with symptoms was 7.45 (0 – 27) years. The elapsed time between diagnosis and the first balloon dilatation was 9.7 (0 – 35) years. 72.2% of dilatations were successful on short-term period without serious complications. 21 patients showed that endoscopic balloon dilatation is effective on long-term period. 13 patients received previously biological therapy in that group. Overall, 21 subjects received biologicals before and 23 subjects after dilatation. 7 subjects had need for surgery due to strictures after balloon dilatation.

Conclusion: The result of this retrospective multicenter study highlights that endoscopic balloon dilatation is an effective therapy of the short strictures in CD with low complication's rate. Using this endoscopic method we can avoid surgical interventions in most of the cases.