Is endoscopic treatment of small bowel strictures effective and safe in patients with Crohn's disease?

INTRODUCTION

there is very little scientific evidence about the efficacy of endoscopic balloon dilation (EBD) performed with balloon-assisted enteroscopy (BAE) for the treatment of small bowel strictures (SBS) in Crohn's disease (CD).

OBJECTIVE

to evaluate the efficacy and safety of EBD using BAE in patients with CD and SBS.

METHODS

a retrospective observational study was performed in a tertiary care medical center in patients with CD and SBS, evaluated by CT enterography or MRI enterography.

RESULTS

from 2009 to 2019, 205 endoscopic dilations were performed in 80 patients with CD. 17 (21.25 %) had only SBS and 70.6 % were male with a median age of 42.2 (±14.4) years. The mean follow-up was 37.8 ±28.7 months. A total of 39 dilations were performed, 94.1 % were native and less than 5cm long, all strictures were ulcerated. The overall technical success was 82.4 % and clinical success was 88.2 %. During follow-up, 23.5 % of patients required surgery and 29.4 % were re-dilated. The long-term efficacy was 76.5 % and no severe adverse events (AE) were observed. No factors were identified to predict the need for surgery after dilation.

CONCLUSIONS

SBS can be safely and effectively treated with EBD using BAE, thus reducing the need for surgery in the long term.