Efficacy of endoscopic balloon dilation for small bowel strictures in patients with Crohn’s disease: A nationwide, multi-center, open-label, prospective cohort study.
J Crohns Colitis. 2017 Nov 29;:
Authors: Hirai F, Andoh A, Ueno F, Watanabe K, Ohmiya N, Nakase H, Kato S, Esaki M, Endo Y, Yamamoto H, Matsui T, Iida M, Hibi T, Watanabe M, Suzuki Y, Matsumoto T
Background and Aims: Endoscopic balloon dilation (EBD) is an alternative to surgery for Crohn’s strictures. However, there have been no prospective studies of EBD for small bowel strictures in patients with Crohn’s disease (CD). The aim of this study was to clarify the efficacy and safety of EBD using balloon-assisted enteroscopy (BAE) for small bowel strictures in CD.
Methods: This was a nationwide, multi-center, open-label, prospective cohort study. The subjects were CD patients with at least one symptom (abdominal pain, abdominal bloating, nausea) attributable to small bowel stricture. The primary endpoint related to short-term outcomes was the level of improvement of symptoms evaluated using a 10-cm visual analogue scale (VAS). Cases in which VAS scores for all symptoms improved four weeks after EBD compared with baseline were considered to have short-term symptomatic improvement. Factors related to short-term treatment outcomes and safety were investigated as secondary endpoints.
Results: A total of 112 patients were enrolled. Seventeen were later excluded because they did not meet the criteria, and the analysis was conducted with the remaining 95 patients. Of these 95 patients, procedure failure occurred in 6 cases (6.3%), and short-term symptomatic improvement was achieved in 66 patients (69.5%). Adverse events were seen in 5 patients (5%) and all improved with conservative treatment. A large dilatation diameter of the balloon was a factor contributing to the success of EBD.
Conclusions: EBD using BAE for small bowel strictures in CD patients was shown to be an effective and safe procedure.
Clinical trial registry: UMIN000005946.
PMID: 29194463 [PubMed – as supplied by publisher]