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DOI: 10.1055/s-0040-1704748
EFFICIENCY AND SAFETY OF ENDOSCOPIC BALLOON DILATION OF ILEOCOLONIC ANASTOMOTIC STRICTURES IN PATIENTS WITH CROHN´S DISEASE: A MULTICENTRIC RETROSPECTIVE STUDY
Publication History
Publication Date:
23 April 2020 (online)
Aims Ileocolonic resection is common in Crohn´s disease (CD). However, stricture formation in the anastomosis is a frequent cause of morbidity and surgery. Endoscopic balloon dilation (EBD) is an established modality for non-surgical treatment of these strictures, however, summary data from the Czech Republic are lacking.
Methods All EBDs of CD anastomotic strictures performed in the 7 centers from the Czech Republic between January 2013 and May 2019 were included. Demographics, disease characteristics, concomitant medication and procedure outcomes with associated complications were analyzed. Technical success was defined as an ability to pass the endoscope following the procedure.
Results In total, 615 procedures performed in 282 patients, 52.1% males, were included. Mean age was 41.9 ± 12.7 years and disease duration 14.5 ± 8.4 years. Single dilation was performed in 47.9% of patients, 52.1% requested repeated interventions (2–10, median 2). Cumulative probability of redilation at 6 months, 1 year and 3 years was 20.2% (95%CI 14.8–26.2%), 31.8% (95%CI 26.5–37.2%) and 59.4% (95%CI 55.5–63.0%), respectively. Cumulative probabilities of a need for reoperation were 4.4% (95%CI 0.5–16.9%), 8.2% (95%CI 2.3–19.3%) and 14.8% (95%CI 7.1–25.2%), respectively. Technical success was reached in 81.1% of procedures and relief of symptoms in 86.7%. Success of the procedure was dependent on age (OR 0.98; 95%CI 0.96–0.99), smoking (OR 0.57; 95%CI 0.32–0.98) and concomitant immunosuppression (OR 1.99; 95%CI 1.31–3.02). Complications occurred in 2.6% of the procedures. Reintervention until 6 months after the procedure was needed in 26.7% of cases, out of which repeated dilation in 21.3% and surgery in 5.4%. The technical success (OR 0.44; 95%CI 0.29–0.67) and repeated dilation (OR 1.57; 95%CI 1.09–2.27) were associated with the need for reintervention until 6 months.
Conclusions In a large multicentric Czech cohort, the EBD in CD anastomotic strictures was proven to be safe and effective with results comparable to the available international data.