Moroi Rintaro, Nochioka Kotaro, Miyata Satoshi, Iwaki Hideya, Chiba Hirofumi, Nagai Hiroshi, Shimoyama Yusuke, Naito Takeo, Shiga Hisashi, Tosa Masaki, Kakuta Yoichi, Kayaba Shoichi, Takahashi Seiichi, Kinouchi Yoshitaka, Masamune Atsushi
Division of Gastroenterology, Tohoku University Hospital, Sendai, Japan.
Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.
Intest Res. 2025 Jul;23(3):302-308. doi: 10.5217/ir.2024.00143. Epub 2025 Jan 21.
BACKGROUND/AIMS: Radial incision and cutting (RIC) is an alternative dilation method for stenosis of the lower gastrointestinal tract. However, its safety and efficacy for the small intestine requiring balloon-assisted enteroscopy (BAE) remain limited. Therefore, this pilot study aimed to evaluate the safety and efficacy of RIC using BAE.
We included 10 patients with Crohn's disease and performed 12 sessions of RIC for 10 lesions. The rate of adverse events 1 month after RIC was the primary outcome, whereas short- and long-term prognoses and improvements in subjective symptoms that were evaluated using a visual analog scale were the secondary outcomes.
The technical success rate for RIC, defined as scope passage immediately following the procedure, was 100% (12/12). The rates of delayed bleeding and perforation were 0% (0/12). One patient developed restenosis because of the worsening of Crohn's disease and underwent surgery 2 months after RIC. The cumulative restenosis-, reintervention-, and surgery-free rates at 1 year after RIC were 67.5%, 78.7%, and 90.0%, respectively. Abdominal pain, abdominal bloating, nausea, and difficulties in defecation significantly improved 4 weeks after RIC.
RIC for small intestine using BAE has the potential to be safe and effective for relieving symptoms (jRCT identifier jRCTs022200040).
背景/目的：径向切开与切割术（RIC）是下消化道狭窄的一种替代扩张方法。然而，其在需要气囊辅助小肠镜检查（BAE）的小肠疾病中的安全性和有效性仍有限。因此，本前瞻性研究旨在评估使用BAE进行RIC的安全性和有效性。
我们纳入了10例克罗恩病患者，对10处病变进行了12次RIC操作。RIC术后1个月的不良事件发生率为主要观察指标，而使用视觉模拟量表评估的短期和长期预后以及主观症状改善情况为次要观察指标。
RIC的技术成功率定义为操作后立即通过内镜，为100%（12/12）。延迟出血和穿孔发生率均为0%（0/12）。1例患者因克罗恩病恶化出现再狭窄，并在RIC术后2个月接受了手术。RIC术后1年的累积无再狭窄、无再次干预和无手术率分别为67.5%、78.7%和90.0%。RIC术后4周，腹痛、腹胀、恶心和排便困难均有显著改善。
使用BAE对小肠进行RIC可能是安全有效的，可缓解症状（jRCT标识符jRCTs022200040）。
