Endoscopic dilation of anastomotic colonic stenosis by different techniques: an alternative to surgery?

Bedogni, G.; Ricci, E.; Pedrazzoli, Claudio; Conigliaro, Rita; Barbieri, I.; Bertoni, G.; Contini, S.; Serafini, Gabriele

doi:10.1016/s0016-5107(87)71479-5

Cited by 53 publications

(23 citation statements)

References 4 publications

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“…Endoscopic balloon dilation has been well documented for benign gastrointestinal stenotic lesions [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], however, there are few reports concerning Crohn's stenosis [24][25][26][27][28][29][30][31][32][33]. Moreover, there is only one study which reported the long-term success rates or complications of endoscopic dilation [30].…”

Section: Introductionmentioning

confidence: 99%

Long‐Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn′s Disease: A Prospective Long‐Term Study

Matsui

Ikeda

Tsuda

et al. 1999

Diagnostic and Therapeutic Endoscopy

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Background The short-and long-term results of balloon dilation therapy in Crohn's patients with non-anastomotic obstructive gastrointestinal lesions are investigated.Materials and methods Fifty-five patients with Crohn's disease who had obstructive gastrointestinal lesions were treated prospectively by endoscopic balloon dilation.Short-term results Eight of the initial dilations were unsuccessful giving no symptomatic relief (14.5%).Long-term results The subjects of the long-term prognosis were 40 cases followed up for more than 6 months (average 37 months) and their strictures were non-anastomotic in more than half (59%). Avoidance of surgery, was possible in 31 of 40 patients (78%). Surgery was avoided in 92%, 81% and 77% of patients after one, two, and three years, respectively (Kaplan-Meier's method). There was no difference in long-term outcome between anastomotic strictures and strictures in the absence of prior surgery.Conclusion Our results suggest that, (1) strictures in the absence of prior surgery might be treated in this way as well as anastomotic strictures; (2) if followed for a prolonged time period, more than 70% of patients, who have undergone balloon dilation for obstructive gastrointestinal Crohn's disease, may be able to avoid surgery. of these underwent balloon dilation in our institute.All the procedures were performed by study members (T.M., S.T., K.Y. and S.S.) in a uniform procedure.Patients Thirty-two of the 55 patients were male. Age at the onset of gastrointestinal symptoms was ranged from 15 to 36 years (average 26.6). The diagnosis of Crohn's disease was confirmed endoscopically, radiographically or histologically. Before obstructive symptoms occurred, their disease had been followed for an average of 7.9 years (range 0.8-10.0). They were classified into 14 small intestinal (6 gastroduodenal), 34 ileocolitis, and 7 colitis type cases. At the time of dilation 32 (58%) had previously undergone surgery. Six patients had gastroduodenal stenoses and 49 patients had ileocolic stenoses. At the time of dilation 45 patients had mild to severe obstructive symptoms and 10 did not have obvious obstructive symptoms but had severe strictures which an endoscope was not able to pass through. These 10 patients had been recieving nutritional therapy (total parenteral nutrition or elemental diet) for active diseases for several weeks and were on nil by mouth. After disease activity had settled down to remission stage (CDAI < 150), colonoscopic evaluation revealed severe stenosis in these patients. They did not have obstructive symptoms because they had not ingest an ordinary diet yet. Seven of the ten asymptomatic patients turned out to be symptomatic during follow-up when on a regular diet. Indications for DilationIndications for balloon dilation were as follows:(1) patients who had strictures in gastroduodenal lesions or ileocolonic lesions, (2) the activity of the disease was quiescent (CDAI < 150, in 48) or not highly active (150 < CDAI < 250, in 7), (3) their general condition was not extremely p...

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Section: Introductionmentioning

confidence: 99%

Long‐Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn′s Disease: A Prospective Long‐Term Study

Matsui

Ikeda

Tsuda

et al. 1999

Diagnostic and Therapeutic Endoscopy

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“…Obstructive, nonmalignant gastrointestinal strictures have been widely treated successfully using this endoscopic procedure. [3][4][5][6][7][8] However, there are few data concerning the long-term results of this treatment for Crohn_s strictures. [9][10][11][12] We investigated the safety and long-term efficacy of endoscopic hydrostatic balloon dilation for intestinal strictures in Crohn_s disease in a retrospective series.…”

mentioning

confidence: 99%

Efficacy and Safety of Endoscopic Balloon Dilation for Crohn's Strictures

Nomura

Takagi

Kikuchi

et al. 2006

Diseases of the Colon &Amp; Rectum

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“…11,14 The real breakthrough came with the introduction of balloon catheter dilation. 3,7,10,[15][16][17][18][19][20][21][22] Advantages of balloon catheter dilation: 1. The dilation force is radial.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Balloon Catheter Dilation of Lower Gastrointestinal Tract Stenoses

Solt

Hertelendy²,

K³

2004

Diseases of the Colon &Amp; Rectum

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Endoscopic dilation of anastomotic colonic stenosis by different techniques: an alternative to surgery?

Cited by 53 publications

References 4 publications

Long‐Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn′s Disease: A Prospective Long‐Term Study

Long‐Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn′s Disease: A Prospective Long‐Term Study

Efficacy and Safety of Endoscopic Balloon Dilation for Crohn's Strictures

Long-Term Results of Balloon Catheter Dilation of Lower Gastrointestinal Tract Stenoses

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