Analysis of the Risk Factors of Surgery after Endoscopic Balloon Dilation for Small Intestinal Strictures in Crohn's Disease Using Double-balloon Endoscopy.
Analysis of the Risk Factors of Surgery after Endoscopic Balloon Dilation for Small Intestinal Strictures in Crohn's Disease Using Double-balloon Endoscopy.
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DOI：
10.2169/internalmedicine.8224-16
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发表时间：
2017-09-01
期刊：
影响因子：
--
通讯作者：
Arakawa T
中科院分区：
文献类型：
--
作者：
Nishida Y;Hosomi S;Yamagami H;Yukawa T;Nagami Y;Tanaka F;Kamata N;Tanigawa T;Shiba M;Watanabe T;Tominaga K;Fujiwara Y;Arakawa T
球囊辅助内窥镜可以使用内窥镜球囊扩张（EBD）进入和治疗小肠狭窄；然而，EBD的长期疗效尚未得到充分评估。本研究评估了EBD在克罗恩病中的长期预后，以确定与后续手术干预需要相关的危险因素。我们回顾性分析了2006年至2015年间在单一中心接受双球囊内窥镜（DBE）治疗小肠狭窄的EBD患者。根据初始EBD后的累计无手术率评估长期结果。在此期间，对37名患者进行了72次EBD和112次手术。随访期间18例（48.6%）患者需要手术治疗。在多变量分析中，与手术需要相关的重要因素是多发性狭窄（校正风险比，14.94；95%可信区间，1.91-117.12;p=0.010）。15例单一狭窄患者中有1例（6.7%）需要手术，而22例多重狭窄患者中有17例（77.3%）需要手术。在多变量分析中，多重狭窄的存在是需要手术的重要危险因素；因此，单一狭窄可能是EBD使用DBE治疗克罗恩病患者小肠狭窄的良好适应症。
Balloon-assisted endoscopy enables access to and treatment of strictures in the small intestine using endoscopic balloon dilation (EBD); however, the long-term outcomes of EBD have not been sufficiently evaluated. This study evaluated the long-term outcomes of EBD in Crohn's disease to identify the risk factors associated with the need for subsequent surgical intervention. We retrospectively analyzed patients with Crohn's disease who had undergone EBD with double-balloon endoscopy (DBE) for small intestinal strictures at a single center between 2006 and 2015. The long-term outcomes were assessed based on the cumulative surgery-free rate following initial EBD. Seventy-two EBD with DBE sessions and 112 procedures were performed for 37 patients during this period. Eighteen patients (48.6%) required surgery during follow-up. Significant factors associated with the need for surgery in a multivariate analysis were multiple strictures (adjusted hazard ratio, 14.94; 95% confidence interval, 1.91-117.12; p=0.010). One patient (6.7%) required surgery among 15 who had single strictures compared to 17 (77.3%) among 22 patients with multiple strictures. In a multivariate analysis, the presence of multiple strictures was a significant risk factor associated with the need for surgery; therefore, a single stricture might be a good indication for EBD using DBE for small intestinal strictures in Crohn's disease patients.
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影响因子：
24.5
作者：
RUTGEERTS, P;GEBOES, K;COREMANS, G
通讯作者：
COREMANS, G
影响因子：
1.9
作者：
Henriksen, Magne;Jahnsen, Jorgen;Moum, Bjorn
通讯作者：
Moum, Bjorn
影响因子：
4.5
作者：
Scimeca, Daniela;Mocciaro, Filippo;Orlando, Ambrogio
通讯作者：
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影响因子：
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作者：
Seastedt, Kenneth P.;Trencheva, Koiana;Nandakumar, Govind
通讯作者：
Nandakumar, Govind
DOI：
10.1155/dte.6.67
发表时间：
2000
期刊：
Diagnostic and therapeutic endoscopy
影响因子：
--
作者：
Matsui, T;Ikeda, K;Tsuda, S;Yao, K;Sou, S;Satoh, S;Hatakeyama, S;Matake, H;Sakurai, T;Yao, T
通讯作者：
Yao, T