Article

Hydrostatic balloon dilatation of Crohn's strictures

Department of Gastroenterology, Hôpital Saint-Louis, Paris, France.
Alimentary Pharmacology & Therapeutics (Impact Factor: 5.48). 09/2003; 18(4):409-13. DOI: 10.1046/j.1365-2036.2003.01715.x
Source: PubMed

ABSTRACT To evaluate the safety and long-term efficacy of per-endoscopic hydrostatic balloon dilatation in a retrospective series of patients with Crohn's disease.
Thirty-eight patients had balloon dilatation for intestinal symptomatic strictures which were located as follows: ileo-colonic (26) or colocolic (2) anastomosis, colon (4), ileum (3), proximal jejunum (1) and ileo-caecal valve (5); three patients had two strictures accessible to dilatation. The mean length of the strictures was 2.1 cm (s.d., 0.3 cm).
Thirty-two of the 38 patients were successfully dilated and followed for a median of 22.8 months (0.2-103 months) until surgery or last news. The probabilities of obstructive symptom recurrence were 36% at 1 year and 60% at 5 years. Twelve patients had a second dilatation, and three a third. The probabilities of surgery for stricture were 26% at 1 year and 43% at 5 years. Results were not influenced by age, sex, activity of the disease, passage of the stricture by the colonoscope or concomitant medical therapies. Complications occurred in 9.4% of the 53 dilatation sessions, with only one perforation.
Hydrostatic balloon dilatation is effective for Crohn's symptomatic strictures, and can avoid or postpone surgery, with an acceptable rate of complications.

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    • "Une méta-analyse de 13 études incluant 347 malades (dans 74 % des cas atteints de sténoses postopératoires) a montré que le succès technique était de 86 % et l'efficacité clinique (pour éviter une chirurgie) de 58 % (obtenue dans 59 % des cas en une seule dilatation, 22 % des cas après 2 dilatations et 19 % des cas après trois) [22]. Une récidive des symptômes est observée dans 40 à 53 % des cas à 1 an et dans 62 à 70 % des cas à 5 ans [21] [23]; une nouvelle dilatation est alors possible [24]. Des complications majeures sont rapportées dans 2 % des cas, dominées par la perforation. "
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