Endoscopic treatment of stenosis in recurrent Crohn's disease with balloon dilation combined with local corticosteroid injection

Ramboer, C.; Verhamme, M; Dhondt, Erik; Huys, Steven; Eygen, Koen Van; Vermeire, Lea

doi:10.1016/s0016-5107(95)70101-x

Cited by 110 publications

(81 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In one case perforation occurred during attempted dilatation of a relapsing stricture (3%). Ramboer et al [12] exclusively used 18 mm balloons in 52 sessions involving 13 patients, without complications. This technique has the additional advantage that the dilatation set can be easily inserted through a standard colonoscope with a www.wjgnet.com A B working channel of 3.2 mm in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…The relapse rate after a single balloon dilatation is probably higher than after surgical intervention [3,4] . Whether additional medical treatment, such as steroid injection into the stricture, as suggested in case reports [7,11,12] , or treatment with steroids after dilatation, can influence the recurrence rate is unknown. Followup studies after surgical bowel resection have shown that, after surgical treatment of Crohn's strictures, local inflammatory signs develop rapidly at the anastomosis without clinical signs of a relapse [22] .…”

Section: Discussionmentioning

confidence: 99%

“…For some time, it has been possible to treat benign strictures of the upper gastrointestinal tract with endoscopic balloon dilatation. Over the past 20 years, this method has become increasingly used for symptomatic Crohn's strictures in the ileum or colon [5][6][7][8][9][10][11][12][13][14][15][16] . The available results indicate equal technical effectiveness of the endoscopic procedures when compared to surgical therapy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Stienecker¹,

Gleichmann²,

Neumayer³

et al. 2009

WJG

View full text Add to dashboard Cite

AIM:To examine the long-term results of endoscopic treatment in a prospective study conducted over a period of 10 years, 1997 to January 2007. METHODS:A total of 25 patients (20 female and five male: aged 18-75 years), with at least one symptom of stricture not passable with the standard colonoscope and with a confirmed scarred Crohn's stricture of the lower gastrointestinal tract, were included in the study. The main symptom was abdominal pain. The endoscopic balloon dilatation was performed with an 18 mm balloon under endoscopic and radiological control.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Stienecker¹,

Gleichmann²,

Neumayer³

et al. 2009

WJG

View full text Add to dashboard Cite

show abstract

“…Balloon dilation has been successfully performed for Crohn's patients with gastrointestinal obstructive lesions [24][25][26][27][28][29][30][31][32][33]. Although there have been some studies which have examined the efficacy of treatment of obstructive ileocolonic Crohn's disease by balloon dilation there are very few long-term studies in which dilations were prospectively performed with a large number of cases [27,30].…”

Section: Discussionmentioning

confidence: 99%

“…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

View full text Add to dashboard Cite

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...

show abstract

A comparison of endoscopic and surgical treatment of strictures in patients with Crohn’s disease

Dubcenco

MacDonald

Feagan

2013

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Endoscopic treatment of stenosis in recurrent Crohn's disease with balloon dilation combined with local corticosteroid injection

Cited by 110 publications

References 9 publications

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

Long-term results of endoscopic balloon dilatation of lower gastrointestinal tract strictures in Crohn’s disease: A prospective study

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

A comparison of endoscopic and surgical treatment of strictures in patients with Crohn’s disease

Contact Info

Product

Resources

About