Efficacy and Safety of Endoscopic Balloon Dilation for Upper Gastrointestinal Strictures of Crohn's Disease.

Abstract

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±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 23.0months (range 6.2-51.2months), 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 1month 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.