Efficacy and Safety of Endoscopic Balloon Dilation for Upper Gastrointestinal Strictures of Crohn's Disease
Efficacy and Safety of Endoscopic Balloon Dilation for Upper Gastrointestinal Strictures of Crohn's Disease
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DOI：
10.1007/s10620-016-4242-y
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发表时间：
2016-10-01
影响因子：
3.1
通讯作者：
Li, Jieshou
中科院分区：
文献类型：
--
作者：
Guo, Feilong;Huang, Yuhua;Li, Jieshou
很少有文章关注内镜下球囊扩张（EBD）治疗上消化道克罗恩病狭窄。EBD治疗上消化道克罗恩病狭窄的长期有效性和安全性，并确定反应和手术干预的早期预测因素。回顾性研究了所有接受EBD治疗上消化道克罗恩病狭窄的合格患者综述长期成功定义为在随访期间恢复正常饮食而无需手术干预。为了寻找早期预测因素，将获得长期成功的患者与未获得长期成功的患者进行比较。2011年6月至2015年3月期间，对24名克罗恩病患者（平均年龄25.6 ± A6.7，20名男性）进行了67次上消化道狭窄扩张。67次扩张中有62次（92.5%）实现了技术成功，并发症发生率为3%。在中位随访期23.0个月（范围6.2-51.2个月）后，9例患者接受了手术干预，9例患者仍依赖管饲;同时，仅6例（25%）患者获得了长期成功。此外，保持1个月无干预的患者（55.6%对5.9%，P = 0.015）更有可能获得长期成功。EBD是一种安全的手术，但不是克罗恩氏上消化道狭窄的有效治疗方法。同时，1个月的反应可以作为长期反应的早期预测。
Few articles focused on endoscopic balloon dilation (EBD) in the management of Crohn's strictures in the upper gastrointestinal (GI) tract.The purpose of this study was to evaluate the long-term efficacy and safety of EBD for Crohn's strictures in the upper GI tract and to determine early predictors of response and surgical intervention.All eligible patients who underwent EBD for Crohn's strictures in the upper GI tract were retrospectively reviewed. The long-term success was defined as the recovery of normal diets without surgical intervention over the follow-up period. In order to seek early predictors, patients who achieved long-term success were compared with those who didn't.A total of 67 dilations of upper GI strictures were performed between June 2011 and March 2015 on 24 patients (mean age 25.6 +/- A 6.7, 20 male) with Crohn's disease. Technical success was achieved in 62 of 67 dilations (92.5 %) with a complication rate of 3 %. After the median follow-up period of 23.0 months (range 6.2-51.2 months), nine patients underwent surgical intervention, nine patients were still depending on tube feeding; in the meantime, only six (25 %) patients achieved long-term success. Additionally, patients who remained 1 month intervention-free (55.6 vs. 5.9 %, P = 0.015) were more likely to achieve long-term success.EBD was a safe procedure, but not a potent therapy for Crohn's upper GI strictures. Meanwhile, 1-month response could serve as an early predictor of the long-term response.