Experience with Balloon Dilatation in Crohn's and Non-Crohn's Benign Small-Bowel Strictures: Is There a Difference?
Journal
Gastroenterology research and practice
ISSN: 1687-6121
Titre abrégé: Gastroenterol Res Pract
Pays: Egypt
ID NLM: 101475557
Informations de publication
Date de publication:
2019
2019
Historique:
received:
26
12
2018
revised:
06
03
2019
accepted:
21
03
2019
entrez:
15
6
2019
pubmed:
15
6
2019
medline:
15
6
2019
Statut:
epublish
Résumé
Endoscopic balloon dilation (EBD) has been effective for small-bowel strictures in patients with Crohn's disease (CD). However, its efficacy and indication for small-bowel strictures in non-CD patients have not been established. This study evaluated the clinical efficacy and safety of EBD for small-bowel strictures in non-CD patients compared with CD patients. Ninety-eight consecutive patients (mean age, 53 years; average observation period, 45 months) with small-bowel strictures diagnosed by double-balloon endoscopy were retrospectively evaluated at Hiroshima University Hospital from August 2003 to April 2017. The average number of procedures, short-term and long-term EBD success rates, and safety profiles between the non-CD and CD groups were examined. Surgery was selected as the initial treatment in 44 cases (45%) (non-CD group, 27 (61%); CD group, 17 (39%)) as EBD is not indicated. Fourteen non-CD patients had strictures due to malignant tumors, while 13 patients had benign strictures. Twenty-three patients (non-CD, 12; CD, 11) underwent EBD. Forty-three EBD procedures were performed for 17 stricture sites (average: 2.5 procedures/site) in non-CD patients and 41 EBD procedures for 18 stricture sites (average: 2.3 procedures/site) in CD patients. The short-term success rate was 100% (23/23), whereas the long-term success rate was 92% (11/12) in non-CD patients and 82% (9/11) in CD patients. No significant differences in the surgery-free rate occurred between both groups. Furthermore, one adverse event, bleeding after EBD, was encountered in the non-CD group (8%, 1/12). EBD for small-bowel strictures demonstrated good clinical outcomes in non-CD patients.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Endoscopic balloon dilation (EBD) has been effective for small-bowel strictures in patients with Crohn's disease (CD). However, its efficacy and indication for small-bowel strictures in non-CD patients have not been established. This study evaluated the clinical efficacy and safety of EBD for small-bowel strictures in non-CD patients compared with CD patients.
METHODS
METHODS
Ninety-eight consecutive patients (mean age, 53 years; average observation period, 45 months) with small-bowel strictures diagnosed by double-balloon endoscopy were retrospectively evaluated at Hiroshima University Hospital from August 2003 to April 2017. The average number of procedures, short-term and long-term EBD success rates, and safety profiles between the non-CD and CD groups were examined.
RESULTS
RESULTS
Surgery was selected as the initial treatment in 44 cases (45%) (non-CD group, 27 (61%); CD group, 17 (39%)) as EBD is not indicated. Fourteen non-CD patients had strictures due to malignant tumors, while 13 patients had benign strictures. Twenty-three patients (non-CD, 12; CD, 11) underwent EBD. Forty-three EBD procedures were performed for 17 stricture sites (average: 2.5 procedures/site) in non-CD patients and 41 EBD procedures for 18 stricture sites (average: 2.3 procedures/site) in CD patients. The short-term success rate was 100% (23/23), whereas the long-term success rate was 92% (11/12) in non-CD patients and 82% (9/11) in CD patients. No significant differences in the surgery-free rate occurred between both groups. Furthermore, one adverse event, bleeding after EBD, was encountered in the non-CD group (8%, 1/12).
CONCLUSION
CONCLUSIONS
EBD for small-bowel strictures demonstrated good clinical outcomes in non-CD patients.
Identifiants
pubmed: 31198420
doi: 10.1155/2019/1262595
pmc: PMC6526561
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1262595Références
Gastrointest Endosc. 2001 Feb;53(2):216-20
pubmed: 11174299
J Clin Oncol. 2001 Sep 15;19(18):3874-83
pubmed: 11559725
Cancer. 2003 May 15;97(10):2462-73
pubmed: 12733145
J Clin Oncol. 2003 Jul 15;21(14):2740-6
pubmed: 12860953
J Clin Pathol. 2004 Nov;57(11):1145-50
pubmed: 15509673
Clin Gastroenterol Hepatol. 2004 Nov;2(11):1010-6
pubmed: 15551254
Gut. 2006 Sep;55(9):1372
pubmed: 16905713
Gastrointest Endosc. 2006 Nov;64(5):835-7
pubmed: 17055891
Gastrointest Endosc. 2006 Dec;64(6):1014-7
pubmed: 17140921
Dig Liver Dis. 2007 Jun;39(6):597-8
pubmed: 17420160
Inflammopharmacology. 2007 Apr;15(2):74-7
pubmed: 17450446
J Int Med Res. 2007 May-Jun;35(3):406-15
pubmed: 17593870
Rinsho Ketsueki. 2007 Jun;48(6):510-3
pubmed: 17633101
Gastrointest Endosc. 2007 Sep;66(3 Suppl):S108-12
pubmed: 17709019
Br J Haematol. 2008 Mar;140(6):712-4
pubmed: 18218049
Am J Gastroenterol. 2008 Oct;103(10):2656-7
pubmed: 18855864
Histopathology. 2008 Oct;53(4):432-40
pubmed: 18983608
Gastrointest Endosc. 2009 Jan;69(1):84-93
pubmed: 19111689
J Gastroenterol. 2009;44 Suppl 19:57-63
pubmed: 19148795
Gastrointest Endosc. 2009 Nov;70(5):1030-6
pubmed: 19640518
Saudi J Gastroenterol. 2007 Jul-Sep;13(3):133-5
pubmed: 19858630
Am J Gastroenterol. 2010 Feb;105(2):289-97
pubmed: 19861953
Gastrointest Endosc. 2010 Feb;71(2):422-5
pubmed: 19896664
Dig Endosc. 2010 Jul;22(3):200-4
pubmed: 20642609
Case Rep Gastroenterol. 2010 Sep 11;4(3):323-329
pubmed: 21060694
Gastrointest Endosc. 2011 Sep;74(3):563-70
pubmed: 21620401
Gastrointest Endosc. 2011 Nov;74(5):1157-61
pubmed: 21924719
Hepatogastroenterology. 2012 Jun;59(116):955-9
pubmed: 22580642
Hepatogastroenterology. 2012 Jun;59(116):1081-6
pubmed: 22580659
Dig Endosc. 2012 Jul;24(4):209-19
pubmed: 22725104
Ann Oncol. 2013 Sep;24(9):2439-43
pubmed: 23704194
Dig Endosc. 2014 Jul;26(4):545-51
pubmed: 24528293
Ann Gastroenterol. 2013;26(2):141-145
pubmed: 24714760
Therap Adv Gastroenterol. 2014 May;7(3):108-14
pubmed: 24790641
Inflamm Bowel Dis. 2016 Feb;22(2):380-6
pubmed: 26535767
Dig Liver Dis. 2016 Apr;48(4):446-8
pubmed: 26725164
Intest Res. 2016 Jan;14(1):89-95
pubmed: 26884740
J Assoc Physicians India. 2016 Feb;64(2):38-47
pubmed: 27730779
World J Gastroenterol. 2016 Oct 28;22(40):9022-9027
pubmed: 27833393
World J Gastroenterol. 2017 Dec 7;23(45):8073-8081
pubmed: 29259383
Med Clin North Am. 1988 Sep;72(5):1091-115
pubmed: 3045452
J Clin Pathol. 1988 May;41(5):516-26
pubmed: 3384981
J Surg Oncol. 1997 Mar;64(3):237-41
pubmed: 9121156
Endoscopy. 1998 Mar;30(3):S44
pubmed: 9615897
J Intern Med. 1998 Jul;244(1):71-8
pubmed: 9698027