Current status of endoscopic balloon dilation for Crohn's disease.
Current status of endoscopic balloon dilation for Crohn's disease.
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DOI：
10.5217/ir.2017.15.2.166
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发表时间：
2017-04
影响因子：
4.9
通讯作者：
Hirai F
中科院分区：
文献类型：
--
作者：
Hirai F
克罗恩病（CD）的治疗目标已提高到实现粘膜愈合。尽管针对细胞因子和其他分子的有效治疗已被广泛用于CD，但肠狭窄仍然是手术的主要原因。内镜球囊扩张术（EBD）是治疗CD肠狭窄的有效且安全的干预措施。由于频繁的肠切除术往往会导致短肠综合征，并会降低生活质量，EBD可以帮助避免手术。EBD联合传统结肠镜治疗克罗恩病性结肠狭窄和回结肠吻合术已确立有效性和安全性。此外，使用气囊辅助肠镜的EBD最近已应用于小肠克罗恩狭窄。尽管证据不充分，但EBD可能成为CD小肠狭窄手术的替代方案。EBD和其他新方法，如自膨式支架植入治疗克罗恩狭窄可能是有用和安全的;然而，重要的是要解决有关这些干预措施的几个问题，并建立一个方案，联合治疗。
The therapeutic target in Crohn's disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery. EBD with a conventional colonoscope for Crohn's strictures of the colon and ileo-colonic anastomosis has established efficacy and safety. In addition, EBD using balloon-assisted enteroscopy has recently been applied for small bowel Crohn's strictures. Although the evidence is not strong, EBD may become an alternative to surgery in small bowel strictures in CD. EBD and other new methods such as self-expanding stent implantation for Crohn's strictures may be useful and safe; however, it is important to address several issues regarding these interventions and to establish a protocol for combined therapies.