Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Medical Oncology, Chiba University Hospital, Chiba, Japan.
Digestion. 2018;98(1):26-32. doi: 10.1159/000486591. Epub 2018 Apr 19.
BACKGROUND/AIMS: Endoscopic balloon dilatation (EBD) is an alternative to surgery for strictures in patients with Crohn's disease (CD). The aim of the present study was to clarify the efficacy and safety of EBD for strictures in patients with CD.
Twenty-six patients with CD who underwent EBD for strictures from August 2008 to November 2015 were followed up after dilatation. Short-term success was defined as the disappearance of obstructive symptoms after technically adequate dilatation was achieved. The short-term success rate of EBD, safety profile of EBD, and cumulative surgery-free and redilatation-free rates were analyzed.
Sixty-five EBDs were performed for CD patients in the follow-up period. The short-term success rate was 100% (26/26), and no complications were encountered during this study. Two (7.7%) patients underwent surgery during the observation period. The cumulative surgery-free rate after the initial EBD was 90.3% at both 2 and 3 years. The cumulative redilatation-free rate after the initial EBD was 52.1% at 2 years and 39.1% at 3 years.
EBD for strictures secondary to CD provides not only short-term success but also long-term efficacy. Although a high redilatation rate is one of the clinical problems of this procedure, EBD is an effective therapy for avoiding intestinal recession in CD -stricture.
背景/目的:内镜下球囊扩张术(EBD)是克罗恩病(CD)患者狭窄的替代手术。本研究旨在阐明 EBD 治疗 CD 狭窄的疗效和安全性。
2008 年 8 月至 2015 年 11 月,对 26 例接受 EBD 治疗的 CD 狭窄患者进行了扩张后的随访。短期成功定义为技术上充分扩张后阻塞症状消失。分析 EBD 的短期成功率、EBD 的安全性概况以及累积无手术和无再扩张率。
在随访期间,对 65 例 CD 患者进行了 65 次 EBD。短期成功率为 100%(26/26),研究过程中未发生任何并发症。2 例(7.7%)患者在观察期间接受了手术。初次 EBD 后 2 年和 3 年的无手术累积率分别为 90.3%和 90.3%。初次 EBD 后 2 年和 3 年的无再扩张累积率分别为 52.1%和 39.1%。
EBD 治疗 CD 引起的狭窄不仅提供了短期疗效,而且具有长期疗效。虽然高再扩张率是该手术的临床问题之一,但 EBD 是避免 CD 狭窄肠退缩的有效治疗方法。