Colonoscopic balloon dilation of Crohn's strictures: a... : European Journal of Gastroenterology & Hepatology (original) (raw)

Original article

a review of long-term outcomes

Thomas-Gibson, Siwan; Brooker, Jim C.; Hayward, Christopher M.M.; Shah, Syed G.; Williams, Christopher B.; Saunders, Brian P.

Wolfson Unit for Endoscopy, St Mark's Hospital, London, UK.

Correspondence to Dr Brian P. Saunders, Wolfson Unit for Endoscopy, St Mark's Hospital, Watford Road, Harrow, London HA1 3UJ, UK. Tel: +44 20 8235 4225; fax: +20 8423 3588; e-mail: [email protected]

Received 15 July 2002 Revised 19 November 2002

Accepted 16 December 2002

European Journal of Gastroenterology & Hepatology 15(5):p 485-488, May 2003. | DOI: 10.1097/01.meg.0000059110.41030.bc

Abstract

Objective

To study the long-term outcomes of patients who have had endoscopic balloon dilation of Crohn's strictures.

Design

Retrospective case-note review over a 16-year period.

Patients

Patients with a Crohn's stricture causing obstructive symptoms and who had at least 6 months' follow-up data or a surgical outcome following dilation were sought; 59 patients (124 dilations) were identified.

Intervention

Patients all underwent endoscopic balloon dilation.

Results

Strictures were anastomotic in 53 patients (111 dilations) and de novo in six patients (13 dilations). The median stricture length was 3.0 cm. Median follow-up time was 29.4 months. Out of the total group, 41% of patients achieved long-term clinical benefit following dilation and in 17% after only a single dilation. The median number of dilations per patient was one. A total of 35 (59%) patients required surgery for their stricture during follow-up. There were two (1.6%) perforations as a result of dilation, one in an anastomotic stricture (managed conservatively) and one in a de-novo stricture (requiring surgery). There were no deaths.

Conclusions

Colonoscopic balloon dilation of Crohn's strictures can achieve long-term clinical benefit in many patients. Repeat dilations are justified in initial nonresponders. In this series, the procedure appears safe with low morbidity.