Abstract
BackgroundsEndoscopic stricturotomy (ESt) has been shown to be effective in treating inflammatory bowel disease (IBD)-associated anastomotic strictures. However, the outcome of ESt in benign, non-IBD conditions has not been described. The aim of this study was to evaluate the outcome of ESt in the management of IBD and non-IBD-associated strictures.MethodsData of all consecutive IBD and non-IBD patients with benign anastomotic strictures treated with ESt from 2009 to 2016 were extracted. The primary outcomes were surgery-free survival and procedure-related complications.ResultsA total of 49 IBD and 15 non-IBD patients were included in this study. The IBD group included 25 patients with Crohn’s disease and 24 with ulcerative colitis and ileal pouches. Underlying diseases in the non-IBD group included colorectal cancer (n = 7), diverticulitis (n = 5), large bowel prolapse (n = 2), and constipation (n = 1). Immediate technical success was achieved in all patients in both groups. Bleeding complications occurred on five occasions (4.7% per procedure) in the IBD group, while no complication occurred in the non-IBD group (P = 0.20). Stricture improvement on follow-up endoscopy was found in 10 (20.4%) and 5 (33.3%) patients in the IBD and non-IBD groups, respectively (P = 0.32). Six (12.2%) patients in the IBD group and four (26.7%) patients in the non-IBD group eventually required stricture-related surgery (P = 0.23). IBD patients appeared to have a higher tendency for maintaining surgery-free after the procedure than non-IBD patients (P = 0.08).ConclusionsEndoscopic stricturotomy was shown to have comparable outcomes, though non-IBD patients seem to have a higher need for subsequent surgery but a lower complication rate than IBD patients.
Highlights
Strictures of the gastrointestinal (GI) tract are classified into primary and secondary types [1]
Various endoscopic approaches such as endoscopic balloon dilation (EBD), endoscopic needle-knife stricturotomy (NKSt) or insulated-tip knife stricturotomy, stent placement, and local injection with long-acting corticosteroids have emerged as valid alternatives [8,9,10,11,12]
A total of 64 patients with benign anastomotic strictures were involved in this study, including 49 inflammatory bowel disease (IBD) and 15 non-IBD patients
Summary
Strictures of the gastrointestinal (GI) tract are classified into primary (disease-related) and secondary types (surgical anastomosis-related) [1]. Anastomotic strictures resulting from fibrosis of the intestinal wall and the lacking of definitive anti-fibrotic drugs in inflammatory bowel disease (IBD) and non-IBD patients have made their management a difficult task [4, 5]. These strictures were traditionally treated with surgical stricturoplasty or additional surgical resection, but the surgical procedures can be technically challenging and the recurrence rate is high [6, 7]. Various endoscopic approaches such as endoscopic balloon dilation (EBD), endoscopic needle-knife stricturotomy (NKSt) or insulated-tip knife stricturotomy, stent placement, and local injection with long-acting corticosteroids have emerged as valid alternatives [8,9,10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
