Endoscopy 2025; 57(S 02): S42
DOI: 10.1055/s-0045-1805172
Abstracts | ESGE Days 2025
Oral presentation
Small intestines: from diagnosis to therapy 03/04/2025, 12:00 – 13:00 Room 120+121

Spindle-Shaped Stricture as a Predictor of Subsequent Surgery after Enteroscopy-Assisted Endoscopic Balloon Dilation for Small Bowel Strictures in Patients with Crohn’s Disease

Authors

  • S N Hong

    1   Samsung Medical Center, Seoul, Republic of Korea

  • J E Kim

    1   Samsung Medical Center, Seoul, Republic of Korea

  • E R Kim

    1   Samsung Medical Center, Seoul, Republic of Korea

  • D K Chang

    2   Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

  • Y H Kim

    3   Samsung medical, Seoul, Republic of Korea
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Aims The long-term outcomes of enteroscopy-assisted endoscopic balloon dilation (EBD) remain poorly documented. In addition, Crohn’s small bowel strictures can be classified into web-like, ulcerated, and spindle-shaped strictures based on endoscopic findings; however, their clinical significance has not been fully evaluated.

Methods This prospective, longitudinal, observational study enrolled patients with Crohn’s disease (CD) who underwent EBD using single-balloon enteroscopy (SBE) for small bowel strictures between 2018 and 2023 at Samsung Medical Center, Seoul, Korea. The primary outcome was to evaluate the cumulative surgery-free rate.

Results A total of 150 consecutive patients who underwent 238 SBE-assisted EBDs were included in this study with mean follow-up of 42.4±19.1 months. After SBE-assisted EBD, 31 patients underwent surgery (20.7%) and 4 patients had major complications (2.7%). The overall cumulative 1-, 3-, and 5-year surgery-free rates were 86.7%, 80.4%, and 76.6%, respectively. According to stricture shape, the cumulative surgery-free rates for web-like, ulcerated, and spindle-shaped strictures were 96.3%, 91.0%, and 73.3% at 1 year, 96.3%, 84.9%, and 63.0% at 3 years, and 96.3%, 78.3%, and 63.0% at 5 years, respectively (p=0.001). Multivariate Cox regression analysis showed that spindle-shaped stricture was associated with surgery (vs. web-like stricture: hazard ratio [HR] 9.20; 95% confidence interval [CI] 1.06 – 80.14, p=0.044).

Conclusions Enteroscopy-assisted EBD for small bowel strictures is an effective and safe treatment modality to avoid surgery in patients with CD. The long-term outcome of small bowel strictures after SBE-assisted EBD depended on the endoscopic classification, with web-like strictures having favorable prognosis and spindle-shaped strictures having poor prognosis.



Publication History

Article published online:
27 March 2025

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