Fumihito Hirai1, Akira Andoh2, Fumiaki Ueno3, Kenji Watanabe4,5, Naoki Ohmiya6,7, Hiroshi Nakase8,9, Shingo Kato10, Motohiro Esaki11, Yutaka Endo3,12, Hironori Yamamoto13, Toshiyuki Matsui1, Mitsuo Iida11,14, Toshifumi Hibi15, Mamoru Watanabe16, Yasuo Suzuki17, Takayuki Matsumoto11,18. 1. Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Zokumyoin, Chikusino, Fukuoka, Japan. 2. Department of Medicine, Shiga University of Medical Science Hospital, Japan. 3. Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital, Japan. 4. Department of Gastroenterology, Osaka City University Graduate School of Medicine, Japan. 5. Department of Intestinal Inflammation Research, Hyogo College of Medicine, Japan. 6. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan. 7. Department of Gastroenterology, Fujita Health University, School of Medicine, Japan. 8. Department of Gastroenterology and Hepatology, Kyoto University, Japan. 9. Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Japan. 10. Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Japan. 11. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Japan. 12. Department of Gastroenterology, Showa University Fujigaoka Hospital, Japan. 13. Department of Medicine, Division of Gastroenterology, Jichi Medical University, Japan. 14. Department of Gastroenterology, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Japan. 15. Center for Advanced IBD Research and Treatment, Kitasato Institute Hospital, Kitasato University, Japan. 16. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan. 17. Internal Medicine, Toho University Sakura Medical Centre, Japan. 18. Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Japan.
Abstract
BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: EBD using balloon-assisted enteroscopy for small bowel strictures in CD patients was shown to be an effective and safe procedure. CLINICAL TRIAL REGISTRY: UMIN000005946.
BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: EBD using balloon-assisted enteroscopy for small bowel strictures in CD patients was shown to be an effective and safe procedure. CLINICAL TRIAL REGISTRY: UMIN000005946.
Authors: Yunhao Zhu; Linyu Ni; Guorong Hu; Laura A Johnson; Kathryn A Eaton; Xueding Wang; Peter D R Higgins; Guan Xu Journal: Biomed Opt Express Date: 2022-05-12 Impact factor: 3.562
Authors: Giovanni Di Nardo; Gianluca Esposito; Chiara Ziparo; Federica Micheli; Luigi Masoni; Maria Pia Villa; Pasquale Parisi; Maria Beatrice Manca; Flavia Baccini; Vito Domenico Corleto Journal: World J Gastroenterol Date: 2020-10-21 Impact factor: 5.742