Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA.
Division of Gastroenterology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Gastrointest Endosc. 2019 Feb;89(2):215-237. doi: 10.1016/j.gie.2018.09.045. Epub 2018 Oct 24.
Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, postsurgical acute or chronic leaks, and obstructions. The endoscopic therapeutic modalities include balloon dilation, stricturotomy, stent placement, fistulotomy, fistula injection and clipping, sinusotomy, EMR, and endoscopic submucosal dissection. With a better understanding of the disease course of IBD, improved long-term impact of medical therapy, and advances in endoscopic technology, we can foresee interventional IBD becoming an integrated part of the multidisciplinary approach to patients with complex IBD.
介入(或治疗性)炎症性肠病(IBD)内镜在疾病治疗和手术不良事件中的作用不断扩大。内镜治疗已在狭窄、瘘管/脓肿、结肠炎相关肿瘤、术后急性或慢性漏管以及梗阻的管理中得到探索和应用。内镜治疗方法包括球囊扩张、狭窄切开术、支架放置、瘘管切开术、瘘管注射和夹闭、窦道切开术、EMR 和内镜黏膜下剥离术。随着对 IBD 疾病过程的更好理解、改善的医学治疗长期影响以及内镜技术的进步,我们可以预见介入性 IBD 将成为治疗复杂 IBD 患者的多学科方法的一个组成部分。