Efficacy Of Endoscopic Balloon Dilation Research Articles

Factors associated with the efficacy and safety of endoscopic dilatation of symptomatic strictures in Crohn’s disease: a retrospective cohort study

Objective Endoscopic balloon dilatation (EBD) is a standard treatment for intestinal strictures in Crohn’s disease (CD). No evidence-based guidelines exist regarding the balloon diameter or the balloon pressure to be used, with recent studies suggesting the use of a smaller diameter than classically used. We sought to analyze the factors associated with safety and efficacy of EBD in CD strictures, particularly looking at balloon diameter and dilatation pressure. Methods We conducted a monocentric retrospective study of patients who underwent EBD between 2005 and 2020. Results Our endoscopy department performed EBD in 94 CD patients during the considered period. The mean size of balloon dilatation was 16 mm (±2.5; including 21 patients with balloon <14 mm) and the mean dilatation pressure was 5.3 atm (±1.5). No perforation was observed. Over a median follow-up of 5.6 years, the probability of being operated was 5.4% at 1 year and 10.4% at 3 years. Smaller height (HR = 0.90, p = 0.022) and a higher BMI (HR = 1.23, p = 0.014) were associated with the risk of operation. The probability of being operated or redilated was 30.1% at 1 year and 52.5% at 3 years. No factor was significantly associated with this risk. The size of the balloon had no impact on outcomes. Conclusion In this retrospective cohort, including a significant proportion of CD patients dilated with balloon <14 mm, no perforation was observed and the size of the balloon or the dilatation pressure had no impact on the risk of surgery or redilatation.

Comparing the efficacy of endoscopic balloon dilation alone and combined with endoscopic sphincterotomy for common bile duct stone: a systematic review and meta-analysis

Several comparative studies have shown that endoscopic balloon dilation (EPBD) combined with endoscopic sphincterotomy (EST) may be a better choice than EPBD alone for the treatment of common bile duct stones (CBDS). However, there are limited data that can be used to compare this combination method with EST or EPBD alone in the treatment of choledocholithiasis. Therefore, this study aimed to systematically evaluate the efficacy of EPBD alone and EPBD combined with EST in the treatment of CBDS. We performed a literature search of the PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases using the following search terms: endoscopic balloon dilation, endoscopic sphincterotomy, sphincterotomy, balloon dilation, gallstones, bile duct stones, and common bile duct stones. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and the network meta-analysis was performed using RevMan 5.20. A total of nine articles satisfied the inclusion criteria, involving 497 patients who received EST + EPBD and 548 patients who underwent EPBD alone. The results of the meta-analysis showed that compared with the EPBD group, the EST + EPBD group had significant differences in the stone removal time [mean difference (MD) is -1.83; 95% confidence interval (CI): (-3.57, -0.10)] and the initial stone removal rate [relative risk (RR) is 1.11; 95% CI: (1.04, 1.19)]. There were no significant differences in the rate of mechanical vibration stone crushing [RR is 0.74; 95% CI: (0.55, 1.00)], total rate of stone removal [RR is 1.01; 95% CI: (0.98, 1.04)], and complication rate [RR is 0.87; 95% CI: (0.66, 1.13)]. The stone removal time and initial stone removal rate of patients in the EST + EPBD group were superior to those of patients in the EPBD group, and the two groups were similar in terms of total stone removal success rate, mechanical lithotripsy (ML) rate, and complication rate. Therefore, large-scale, multi-center prospective studies are needed to clarify whether EST + EPBD is superior to EPBD alone in the treatment of choledocholithiasis.

Long-term outcomes of endoscopic balloon dilation for intestinal strictures in patients with Crohn's disease during maintenance treatment with anti-tumor necrosis factor alpha antibodies.

Efficacy of endoscopic balloon dilation (EBD) for intestinal strictures in patients with Crohn's disease (CD) receiving anti-tumor necrosis factor alpha antibodies (anti-TNF) as maintenance therapy is unclear. We investigated the long-term efficacy and safety of EBD for intestinal strictures in patients with CD receiving anti-TNF. We retrospectively analyzed data from patients with CD who received anti-TNF as maintenance therapy from 2008 to 2017, underwent EBD, and were followed up for ≥6 months. The primary endpoint was the cumulative surgery-free rate. The main secondary endpoints were technical success, repeat EBD rate, risk factors affecting surgical outcomes, and safety. Seventy-two patients with CD were assessed. The median observation period after EBD was 50 months. The technical success rate was 67%. The 3- and 5-year cumulative surgery-free rates were 81.1% and 73.5%, respectively. The repeat EBD rate was 74%. Multivariable analyses showed that risk factors affecting surgical outcomes were age at disease onset ≤16 years (hazard ratio 3.69; 95% confidence interval 1.36-10.01; P = 0.011). Serious complications requiring surgery developed in three patients. Endoscopic balloon dilation was an effective and safe short-term treatment and a useful long-term treatment for CD patients with intestinal strictures receiving anti-TNF as maintenance therapy.

Is endoscopic treatment of small bowel strictures effective and safe in patients with Crohn's disease?

there is very little scientific evidence about the efficacy of endoscopic balloon dilation (EBD) performed with balloon-assisted enteroscopy (BAE) for the treatment of small bowel strictures (SBS) in Crohn's disease (CD). to evaluate the efficacy and safety of EBD using BAE in patients with CD and SBS. a retrospective observational study was performed in a tertiary care medical center in patients with CD and SBS, evaluated by CT enterography or MRI enterography. from 2009 to 2019, 205 endoscopic dilations were performed in 80 patients with CD. 17 (21.25 %) had only SBS and 70.6 % were male with a median age of 42.2 (±14.4) years. The mean follow-up was 37.8 ±28.7 months. A total of 39 dilations were performed, 94.1 % were native and less than 5cm long, all strictures were ulcerated. The overall technical success was 82.4 % and clinical success was 88.2 %. During follow-up, 23.5 % of patients required surgery and 29.4 % were re-dilated. The long-term efficacy was 76.5 % and no severe adverse events (AE) were observed. No factors were identified to predict the need for surgery after dilation. SBS can be safely and effectively treated with EBD using BAE, thus reducing the need for surgery in the long term.

Treatment of inflammatory bowel disease-relevant strictures by double balloon enteroscopy

To evaluate the safety and efficacy of endoscopic balloon dilation (EBD) and endoscopic stricturotomy with needle knife (NKSt) in patients with inflammatory bowel diseases (IBD)-relevant strictures. Methods: From July 2015 to September 2018, 14 patients undergoing double balloon-enteroscopy at the Third Xiangya Hospital of Central South University were enrolled. There was a total of 16 lesions. Endoscopic intervention was performed for 16 times. EBD was done for 11 times, and 5 stricturotomies were carried out. Regular follow-up and examinations were done to observe whether there was remission or recurrence of clinical symptoms and replacement surgery. Results: All 14 patients were successfully treated by endoscopy, and the success rate was 100%. Postoperative clinical symptoms were alleviated, and serious complications, such as perforation or hemorrhaging, did not occur. Obstructive symptoms were effectively alleviated at a median follow-up of 26.1 months (5.9-35.3 months) and 8.3 months (1.6-17.8 months) for patients with balloon dilatation and stricturotomy, respectively. Two patients presented with symptoms of obstruction. These were given conservative symptomatic treatment without surgical intervention. Conclusion: Enteroscopic treatments (EBD and NKSt) are safe and effective for intestinal strictures, and can prolong the time before surgical intervention is needed.

Efficacy and safety of endoscopic balloon dilation in inflammatory bowel disease: results of the large multicenter study of the ENEIDA registry.

There is no information regarding the outcome of Crohn's disease (CD) patients treated with endoscopic balloon dilation (EBD) in non-referral hospitals, nor on the efficacy of EBD in ulcerative colitis (UC). We report herein the results of the largest series published to date. To assess the efficacy and safety of EBD for inflammatory bowel disease (IBD) stenosis performed in 19 hospitals with different levels of complexity and to determine factors related to therapeutic success. We identified IBD patients undergoing EBD in the ENEIDA database. Efficacy of EBD was compared between CD and UC and between secondary and tertiary hospitals. Predictive factors of therapeutic success were assessed with multivariate analysis. Four-hundred dilations (41.2% anastomotic) were performed in 187 IBD patients (13 UC/Indeterminate colitis). Technical and therapeutic success per dilation was achieved in 79.5% and 55.3%, respectively. Therapeutic success per patient was achieved in 78.1% of cases (median follow-up: 40months) with 49.7% requiring more than one dilation. No differences related to either diagnosis or hospital complexity was found. Technical success [OR 4.12 (95%CI 2.4-7.1)] and not receiving anti-TNF at the time of dilation [OR 1.7 (95% CI 1.1-2.6)] were independently related to therapeutic success per dilation. A stricture length ≤ 2cm [HR 2.43 (95% CI 1.11-5.31)] was a predictive factor of long-term success per patient. The rate of major complications was 1.3%. EBD can be performed with similar efficacy and safety in hospitals with differing levels of complexity and it might be a suitable treatment for UC with short stenosis. To achieve a technical success and the short length of the stenosis seem to be critical for long-term therapeutic success.

Endoscopic Balloon Dilatation in the Treatment of Benign Ureteral Strictures: A Meta-Analysis and Systematic Review.

Although balloon dilatation is one of the main endoscopic procedures used to treat benign ureteral strictures, its precise efficacy remains controversial. We aimed to identify, combine, and analyze existing published data to ascertain the efficacy of endoscopic balloon dilatation for benign ureteral strictures. In December 2018, a literature search was performed using Medline, Embase, and Web of Science databases. We included reports in which the study population consisted of patients who underwent endoscopic balloon dilatation for the treatment of benign ureteral strictures. Technical, short-term, and long-term success rates (expressed as mean ± standard error) were adopted as the outcome measures. Using our search strategy, a total of 19 studies (all series reports) were included for analysis. Using a random-effects model, the pooled technical success rate of endoscopic balloon dilatation for benign ureteral strictures was found to be 89% ± 4%. Furthermore, the short-term success rate (i.e., 3 months after surgery) was 60% ± 10%, and the long-term success rate (i.e., 6-12 months after surgery) was 54% ± 14%. In the subgroup analysis, the success rate of endoscopic balloon dilatation for ≤2-cm benign ureteral strictures was significantly higher than that for >2-cm ones (odds ratio [OR]: 0.13; 95% confidence interval [CI]: 0.05-0.35). In addition, the success rate in cases with strictures of onset timing ≤3 months was relatively higher than that in cases with strictures of onset timing >3 months (OR: 0.46; 95% CI: 0.15-1.43). Our study indicates that endoscopic balloon dilatation has a high success rate in the treatment of benign ureteral strictures with length ≤2 cm and onset timing ≤3 months. However, there is still no consensus on balloon type, dilatation pressure, expansion number, postoperative ureteral stent type, and stent retention time for the balloon dilatation technique.

P713 Long-term efficacy of endoscopic balloon dilatation using single-balloon enteroscopy in patients with Crohn’s disease

P713 Long-term efficacy of endoscopic balloon dilatation using single-balloon enteroscopy in patients with Crohn’s disease

A clinical study of endoscopic balloon dilation in treatment of esophageal stenosis after neonatal esophageal atresia surgery

Objective To explore the feasibility and efficacy of endoscopic balloon dilation in treatment of esophageal stenosis caused by operation of congenital esophageal atresia. Methods A retrospective analysis was performed on data of 218 children with type Ⅲ esophageal atresia, who underwent surgery in Zhengzhou Children′s Hospital from January 2009 to December 2017. The occurrence of postoperative complications and efficacy of endoscopic balloon dilation in treatment of esophageal stenosis was analyzed. Results Among the 218 patients with congenital esophageal atresia, 92 were type Ⅲa and 126 were type Ⅲb. Postoperative anastomotic leakage occurred in 46 cases (21.1%), including 29 (31.5%) of type Ⅲa and 17 (13.5%) of type Ⅲb. Postoperative anastomotic stenosis occurred in 53 cases (24.3%), including 29 (31.5%) of type Ⅲa and 24 (19.0%) of type Ⅲb. The incidence of anastomotic leakage and anastomotic stenosis in different types was significantly different (χ2=10.383, P=0.001; χ2=4.497, P=0.034). The 53 cases of anastomotic stenosis underwent 123 times of endoscopic balloon dilation, with mean time of 3.5±1.6, and were finally clinically recovery. No esophagus perforation occurred. Among them, 29 cases of type Ⅲa underwent 73 times with mean of 4.0±1.8, and 24 cases of type Ⅲb underwent 50 times with mean of 2.5±0.7. The difference between the two types was statistically significant (t=-4.053, P=0.027). Conclusion Children with type Ⅲa esophageal atresia has a higher incidence of anastomotic stenosis and leakage, and more times of esophageal dilation. Endoscopic balloon dilation is safe and effective in treatment of esophageal stenosis after surgery for patients with congenital esophageal atresia. Key words: Child; Esophageal atresia; Esophageal stenosis; Endoscopic balloon dilation

توسع البالون بالمنظار مقابل بضع العضلة العاصرة في حالات اليرقان الانسدادي الجليدي أثناء تصوير البنكرياس بالتصوير الوراثي بالمنظار

منذ ادخاله عام ١٩٦٨، أصبح منظار القنوات المرارية شائع الاستخدام و أصبح استخدامه في مجال التشخيص و العلاج لحالات حصوات القنوات المرارية وذلك باستخدام الشق المنظاري لعاصرة القناة المرارية واستخراج الحصوات بواسطة بالون أو سلة الاستخراج , و يعتبر الشق المنظاري لعاصرة القناة المرارية من أكثر الطرق شيوعا لعلاج حصوات القنوات المرارية ، و برغم التطور الذي طرأ علي هذا التقنية إلا أنه ما زال يواجه بعض التحديات. لقد تم إدخال التوسيع المنظاري بالبالونة لعاصرة القناة المرارية لأول مرة عام ١٩٨٣ و تم إعادة تقييمه مرة أخري ليكون بديلا للشق المنظاري بعدما ثبتت أهميته في عام ١٩٩٤ و لأن التوسيع المنظاري بالبالونة يعتمد علي توسيع عاصرة القناة المرارية و ليس القطع فإن نسبة حدوث النزف تعتبر ضئيلة جدا و لذا يمكن إستخدام التوسيع المنظاري بالبالونة بديلا للشق المنظاري في المرضي المصابين بإرتفاع السيولة في الدم دون زيادة في نسبة حدوث إلتهاب البنكرياس او النزف. الهدف من الدراسة: هو المقارنة بين كلا من التوسيع المنظاري بالبالونة و الشق المنظاري من حيث مدي نجاح كلا منهما في إزالة حصوات القنوات المرارية , مدي حدوث المضاعفات. خطوات الدراسة: أجريت الدراسة علي خمسين مريضا يعانون من حصوات القنوات المرارية و قد خضعوا لإجراء منظار القنوات المرارية في مستشفى الحسين الجامعى فى الفترة من أكتوبر 2015 حتى أبريل 2016 وتم تقسيم المرضي عشوائيا إلي مجموعتين هما المجموعة الأولي شملت خمس وعشرون مريضا تم إجراء الشق المنظاري لهم. والمجموعة الثانية و شملت خمس وعشرون مريضا تم إجراء التوسيع المنظاري بالبالونة لهم. وقد تم تقييم مدى نجاح كلا من الطريقتين فى استخراج الحصوات ومتابعة المضاعفات الوارد حدوثها أثناء وبعد عمل المنظار نتائج الدراسة : وقد تبين من هذه الدراسة تقارب معدلات نجاح كلا من الطريقتين لاستخراج الحصوات بما يعادل 88% من مرضى الشق المنظارى و 80% من مرضى التوسيع المنظارى بالبالون. كما وجدت من خلال هذه الدراسة تقارب معدلات المضاعفات فى كلا المجموعتين كما أثبتت الدراسة أنه أثناء إجراء المنظار يكون معدل حدوث النزيف فى حالات الشق المنظارى أكبر منه وذو دلالة أحصائية فى حالات التوسيع البالونى 64% مقابل 16%. وقد أثبتت هذه الدراسة حدوث نزيف بعد المنظار بمعدل أكبر وذات دلالة احصائية فى مرضى الشق المنظارى بنسبة 24% والتى تعد من أهم وأخطر المضاعفات التى قد تودى بحياة المرضى ، مقابل أن هذا الأمر لم يحدث فى مرضى مجموعة التوسيع بالبالون. وقد خلصت هذه الرسالة الى تساوى كلا من الشق المنظارى والتوسيع المنظارى بالبالون فيما يتعلق بمدى نجاح كلا من الطريقتين فى استخراج حصوات القنوات المرارية و كذلك نستنتج من هذه الدراسة، حدوث نزيف أثناء المنظار بمعدل أكبر أثناء الشق المنظارى ولذلك يفضل التوسيع المنظارى بالبالون عن الشق المنظارى أثناء أداء منظار القنوات المرارية لاستخراج حصوات القناة المرارية فى المرضى الذين يعانون من ارتفاع سيولة الدم كمرضى التليف الكبدى والمرضى المستخدمين لأدوية السيولة.

Efficacy of Endoscopic Balloon Dilation for Small Bowel Strictures in Patients With Crohn's Disease: A Nationwide, Multi-centre, Open-label, Prospective Cohort Study.

Endoscopic balloon dilation [EBD] is an alternative to surgery for Crohn's strictures. However, there have been no prospective studies of EBD for small bowel strictures in patients with Crohn's disease [CD]. The aim of this study was to clarify the efficacy and safety of EBD using balloon-assisted enteroscopy for small bowel strictures in CD. This was a nationwide, multi-centre, open-label, prospective cohort study. The subjects were CD patients with at least one symptom [abdominal pain, abdominal bloating, nausea] attributable to small bowel stricture. The primary endpoint related to short-term outcomes was the level of improvement of symptoms evaluated using a 10-cm visual analogue scale [VAS]. Cases in which VAS scores for all symptoms improved 4 weeks after EBD compared with baseline were considered to have short-term symptomatic improvement. Factors related to short-term treatment outcomes and safety were investigated as secondary endpoints. A total of 112 patients were enrolled. Seventeen were later excluded because they did not meet the criteria, and the analysis was conducted with the remaining 95 patients. Of these 95 patients, procedure failure occurred in six [6.3%], and short-term symptomatic improvement was achieved in 66 patients [69.5%]. Adverse events were seen in five patients [5%] and all of these improved with conservative treatment. A large dilation diameter of the balloon was a factor contributing to the success of EBD. EBD using balloon-assisted enteroscopy for small bowel strictures in CD patients was shown to be an effective and safe procedure. UMIN000005946.

Endoscopic Balloon Dilatation vs. Sphincterotomy in Cases of Calcular Obstructive Jaundice during Endoscopic Retrograde Cholangio Pancreatography

Background: Compared to Endoscopic sphincterotomy (ES), endoscopic balloon dilation (EBD) has been reported to have a lower risk of bleeding but an increased risk of post-ERCP pancreatitis. Additionally, removal of large stones may be challenging when using EBD alone. Patients and methods: 50 patients with calculary obstructive jaundice was enrolled in our randomized comparative study, ES was done for have of them and EBD for the rest. During ERCP, stone removal was declared as complete if the final cholangiogram showed no residual stones. Clinical evaluation for post ERCP pancreatitis was performed on the following day by symptoms and serum amylase. Results: There is no statistical significant difference between the two groups, as regard, procedure duration, cannulation trials and time. Success rate was 88% and 80 after ES and EBD respectively. Significant higher rates of endoscopic bleeding were detected with ES. Apart from significant higher rates of post-ERCP bleeding after ES, no difference was detected between the 2 groups at regard post-ERCP complications. Conclusion: The efficacy of EBD is similar to ES regarding, removal of common bile duct stones, and it can be safely applied particularly in patients with systemic coagulopathy as it carries a lower rate of bleeding. Further study evaluating the combined ES and EBD is highly recommended.

Endoscopic balloon dilatation of Crohn's strictures: a safe method to defer surgery in selective cases.

Endoscopic balloon dilatation (EBD) provides a valuable alternative to surgery for strictures in Crohn's disease (CD). Data are lacking regarding the factors that improve the safety and effectiveness of EBD in CD. The aim of this study is to determine the safety and efficacy of EBD and the clinical variables, which are predictive of successful treatment of CD strictures with EBD. The records of all patients with CD in whom EBD was attempted between 2008 and 2013 were reviewed. Procedures were conducted at a single tertiary referral centre using a Boston Scientific CRE® TTS balloon. Technical success was defined as the ability to traverse the stricture with the endoscope and clinical success as the resolution of obstructive symptoms at review. Forty-seven patients with a total of 58 strictures (19 primary and 39 anastomotic strictures) were treated with EBD with median follow-up of 37 months. A total of 161 dilatation procedures were performed, with technical success reported in 139/158 (88%) cases and clinical success reported in 105/137 (76.7%) cases with complete data. Complications occurred in 7/161 dilatations (4.3% dilatations, 15% patients), three patients with perforation, one with acute bleeding and three admitted with abdominal pain. Eighteen of the 47 patients required surgery (38%). Strictures of <50 mm (P = 0.04) and those dilated to a diameter of ≥15 mm (P = 0.031) were less likely to require surgical resection. EBD is safe for both primary and post-surgical strictures. Stricture length and diameter of dilatation are predictive of success. In selected patients, treatment with EBD may reduce or delay the need for surgery.

Management of subglottic stenosis in children with endoscopic balloon dilation

To evaluate the efficacy of endoscopic balloon dilation for subglottic stenosis. The clinical outcomes of 9 pediatric patients treated with balloon dilation were retrospectively analyzed. There were 8 male and 1 female. Their age ranged from 7 months to 7 years (mean 2.5 years). The degree of stenosis was classified according to Myer-Cotton classification as follows: grade Ⅱ (n=7) and grade Ⅲ (n=2). The causes of the stenosis were postintubation lesions (n=8) and laryngeal penetrating trauma (n=1). The patients had undergone 1 to 3 dilations with an average of 1.8 procedures per patient. Six (66.7%) patients were decannulated. Among them, 4(44.4%) were decannulated after one dilation procedure. Pneumothoraces occurred in 2 children postoperatively. Endoscopic balloon dilation is an effective, relatively safe and minimally invasive surgical method for patients with low-grade subglottic stenosis.

Endoscopic minor papilla balloon dilation for the treatment of symptomatic pancreas divisum.

A subpopulation of patients with pancreas divisum experience symptomatic events such as recurrent acute pancreatitis and chronic pancreatitis. Minor papilla sphincterotomy has been reported as being an effective treatment. The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilation for the minor papilla. Between 2000 and 2012, 16 patients were retrospectively included in this study. After endoscopic balloon dilation for the minor papilla was received, a pancreatic stent or a nasal pancreatic drainage catheter was placed for 1 week. If a stricture or obstruction was evident, it was treated with balloon dilation followed by long-term stent placement (1 year). When an outflow of pancreatic juice was disturbed by a pancreatic stone, endoscopic stone extraction was performed. Balloon dilation and stent placement were achieved and were successful in all the cases (16/16; 100%). Clinical improvement was achieved in 7 (84.7%) of the 9 patients with recurrent acute pancreatitis and in 6 (85.7%) of the 7 patients with chronic pancreatitis. Early complications were observed in 1 (6.3%) patient. Pancreatitis or bleeding related to balloon dilation was not observed. Endoscopic balloon dilation for the minor papilla is feasible for the management of symptomatic pancreas divisum.

Efficacy of endoscopic balloon dilatation, stenting and surgery in treating corrosive esophageal stricture of 31 children

To evaluate the efficacy of endoscopic balloon dilatation, stenting and surgery in treating corrosive esophageal stricture of children. We retrospectively analyzed the management of 31 children who were treated with endoscopic balloon dilatation, stenting or gastric tube esophagoplasty because of corrosive esophageal stricture between August 2005 and December 2012. Dysphagia was graded into 4 grades according to Stooler grading methods. The efficacy was divided into 3 grades which were very effective, effective and ineffective according to the improvement of dysphagia. Among 31 children with corrosive esophageal stricture, in 22 children the problem was caused by alkali, in 9 by acid; 23 children had long-segment stricture and 8 had short-segment stricture. The number (rates) of cases in whom the endoscopic balloon dilatation was very effective, effective, and ineffective were 12 (38.7%) , 7 (22.6%) , 12 (38.7%) , respectively. The number of cases in whom stenting was effective or ineffective was 1 and 3, respectively. The gastric tube esophagoplasty was very effective and effective in 8 and 2 cases, respectively. Total rates of very effective, effective, and ineffective of 3 treatments were 64.5%, 29%, 6.5% respectively. The efficacy of endoscopic balloon dilatation was better in short-segment stricture and bigger caliber stricture, the efficacy was not so good for other types of strictures. The efficacy of balloon dilatation was not related with the nature of substances (either alkaline or acidic). Compared with very effective group, the ineffective group with longer course of disease before dilatation (t = -2.091, P = 0.048) , smaller stricture calibre (t = 2.855, P = 0.009) , longer stricture segment (t = -3.405, P = 0.003) and longer dilatation time (t = -2.103, P = 0.047) , had statistical significance. Endoscopic balloon dilatation was the preferred treatment for corrosive esophageal stricture of children. The efficacy was better in shorter course of disease, short-segment stricture and bigger caliber stricture, for other situations the efficacy was not so good. The efficacy of balloon dilatation was not related with the nature of substances.Stent or surgery can be considered if efficacy of balloon dilatation was not so good.Gastric tube esophagoplasty is an effective treatment for complicated corrosive esophageal stricture.

Endoscopic balloon dilatation for benign esophageal stricture after endoscopic submucosal dissection for early esophageal neoplasms

The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilatation (EBD) for benign esophageal strictures after ESD for early esophageal neoplasms. Data of 335 patients who were treated with ESD for early esophageal neoplasms from October 2006 to August 2012 were retrospectively reviewed. The characteristics of the patients who underwent EBD for post-ESD stricture were analyzed. A total of 117 dilatation procedures were performed in 29 patients with post-ESD esophageal stricture. The mean number of EBD sessions was 4.0 (range 1-15) and no complications occurred during the procedures. The median follow-up period for the 29 patients since their last session of EBD was 20 months (range 1-48 months). Of the 28 patients who were followed up for more than 3 months after achieving dysphagia relief, two had recurrent dysphasia and EBD was reintroduced. The treatment success rate was 92.9% (26/28). EBD is a safe and effective modality for the treatment of benign esophageal stricture after ESD for early esophageal neoplasms.

Sa1653 Efficacy of Endoscopic Balloon Dilation for Stenosis in Small Intestine

Sa1653 Efficacy of Endoscopic Balloon Dilation for Stenosis in Small Intestine

Sa1661 Safety and Efficacy of Endoscopic Balloon Dilation for Gastrojejunal Anastomotic Stenosis After Roux-en-Y Gastric Bypass: a Meta-Analysis

Sa1661 Safety and Efficacy of Endoscopic Balloon Dilation for Gastrojejunal Anastomotic Stenosis After Roux-en-Y Gastric Bypass: a Meta-Analysis

Prior use of immunomodulatory drugs improves the clinical outcome of endoscopic balloon dilation for intestinal stricture in patients with Crohn's disease

Endoscopic balloon dilation is a promising procedure to improve symptoms of intestinal stricture in patients with Crohn's disease (CD). However, the long-term efficacy of endoscopic balloon dilation combined with immunomodulatory drugs remains unclear. The aim of the present study is to investigate whether prior use of immunomodulatory drugs affects the clinical outcome of endoscopic balloon dilation for intestinal stricture in CD. Between January 2004 and December 2011, 83 dilations were carried out in 25 patients with CD. Median follow-up period was 46 months. Patients were categorized into two groups based on their medications at the first endoscopic balloon dilation: early immunomodulatory drug-induction group (early IM-induction group) in which patients were already treated with immunomodulatory drugs before the dilation; and post-immunomodulatory drug-induction group (post-IM-induction group) in which patients were not yet treated withimmunomodulatory drugs before dilation. We compared the long-term cumulative non-surgical rate and the mean number of dilation procedures per patient between early and post-IM-induction groups to clarify the influence of prior use of immunomodulatory drugs on the clinical outcome of endoscopic balloon dilation. There was a significant difference in the mean number of dilation procedures per patient between the early IM-induction and post-IM-induction groups (P = 0.04), although no significant difference in the cumulative non-surgical rate was observed between the two groups (P = 0.14). Prior use of immunomodulatory drugs may improve the clinical outcome of endoscopic balloon dilation for intestinal stricture in CD.