Efficacy and safety of endoscopic balloon dilation of symptomatic intestinal Crohn's disease strictures
Efficacy and safety of endoscopic balloon dilation of symptomatic intestinal Crohn's disease strictures
复制标题
DOI：
10.1016/j.dld.2010.05.001
复制
发表时间：
2011-02-01
影响因子：
4.5
通讯作者：
Orlando, Ambrogio
中科院分区：
文献类型：
--
作者：
Scimeca, Daniela;Mocciaro, Filippo;Orlando, Ambrogio
目的：前瞻性评价内窥镜静压球囊扩张术治疗症状性肠克罗恩病狭窄的临床疗效和安全性。方法：2003年9月至2008年12月，我们对37例克罗恩病患者进行了内镜下球囊扩张术，其中39例有症状性肠道狭窄（4例初治，35例术后）。使用Rigiflex通过镜球囊进行扩张。如果患者在技术成功后仍然无症状，不需要手术或进一步的内窥镜扩张，则声称临床成功率。应用Kaplan-Meier法获得临床、内镜（再扩张）和手术复发的精算曲线。人口统计学和疾病变量与主要结局相关。结果：平均随访26.3个月（范围2-61个月）后，长期整体获益率为89%（33/37）。1-2-3年累计无症状率分别为76%、55%和46%。4个病人做了手术。技术上的成功预示着较低的手术率。没有与内窥镜手术相关的并发症。结论：内镜下球囊扩张治疗有症状的克罗恩病狭窄对许多患者都有临床益处，是治疗该疾病的有效替代方法。复发性肠梗阻可重复扩张，且安全无并发症。(C) 2010年意大利胃肠病学主编，爱思唯尔有限公司出版版权所有。
Aim: To evaluate prospectively the clinical efficacy and safety of endoscopic hydrostatic balloon dilation in a consecutive cohort of symptomatic intestinal Crohn's disease strictures.Methods: Between September 2003 and December 2008 we performed endoscopic balloon dilations in 37 Crohn's disease patients with 39 intestinal symptomatic strictures (4 naive and 35 postoperative). Dilations were performed using a Rigiflex through-the-scope balloon. Clinical success rate was claimed if a patient remained asymptomatic and did not require surgery or further endoscopic dilation, following technical success. Actuarial curves of clinical, endoscopic (redilation) and surgical recurrence were obtained by Kaplan-Meier method. Demographic and disease variables were related to the main outcomes.Results: After a mean follow-up of 26.3 months (range, 2-61 months), the long-term global benefit rate was 89% (33/37). The 1-2-3 years cumulative symptom-free rates were respectively: 76%, 55% and 46%. Four patients were operated upon. Technical success predicts a lower rate of surgery. There were no complications related to the endoscopic procedures.Conclusions: Endoscopic balloon dilation of symptomatic Crohn's disease strictures may achieve clinical benefit in many patients and is a valid alternative to surgery in the management of the disease. Dilation may be repeated in recurrent intestinal obstructions and appears safe without morbidity. (C) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.