Endoscopic balloon dilatation effective for stricturing CD

Endoscopic balloon dilatation allows most Crohn’s disease patients who develop strictures to avoid surgery, experience from Australian centres shows.

A retrospective audit of outcomes of 544 endoscopic balloon dilatation (EBD) procedures in 11 Australian and New Zealand centres found that technical success, defined as the ability to traverse the stricture following dilatation, was achieved in 83% of cases.

In findings presented at ECCO 2019 for 236 patients with stricturing CD (294 anastomotic and 245 de novo procedures), clinicians from Queensland showed that only 55 patients (23%)  required surgery following EBD.

The average time to surgery after EBD was 8 months, according to the data presented by Dr Emily Lim and colleagues from the Queen Elizabeth II Jubilee Hospital, Brisbane.

The retrospective study also showed that long stricture length (>4cm), ileal involvement and active inflammation were risk factors for dilatation failure (Hazard Ratios of 7.5, 3.2 and 2.3 respectively).

The median age at the time of procedures was 46 years (vs median age at diagnosis of 25 years)  and the dilation diameter range was 8-20mm (median 15mm).

There were no major bleeding or mortality events and the only complications of EBD were perforation (3 cases) and two aspiration events.

“Among a large cohort of Crohn’s disease patients EBD is a safe procedure which can be used in stricturing CD with a high technical success rate,” they concluded.

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