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Eur J Gastroenterol Hepatol. 2003 May;15(5):485-8.

Colonoscopic balloon dilation of Crohn's strictures: a review of long-term outcomes.

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1
Wolfson Unit for Endoscopy, St Mark's Hospital, London, UK.

Abstract

OBJECTIVE:

To study the long-term outcomes of patients who have had endoscopic balloon dilation of Crohn's strictures.

DESIGN:

Retrospective case-note review over a 16-year period.

PATIENTS:

Patients with a Crohn's stricture causing obstructive symptoms and who had at least 6 months' follow-up data or a surgical outcome following dilation were sought; 59 patients (124 dilations) were identified.

INTERVENTION:

Patients all underwent endoscopic balloon dilation.

RESULTS:

Strictures were anastomotic in 53 patients (111 dilations) and de novo in six patients (13 dilations). The median stricture length was 3.0 cm. Median follow-up time was 29.4 months. Out of the total group, 41% of patients achieved long-term clinical benefit following dilation and in 17% after only a single dilation. The median number of dilations per patient was one. A total of 35 (59%) patients required surgery for their stricture during follow-up. There were two (1.6%) perforations as a result of dilation, one in an anastomotic stricture (managed conservatively) and one in a de-novo stricture (requiring surgery). There were no deaths.

CONCLUSIONS:

Colonoscopic balloon dilation of Crohn's strictures can achieve long-term clinical benefit in many patients. Repeat dilations are justified in initial non-responders. In this series, the procedure appears safe with low morbidity.

[Indexed for MEDLINE]

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