Endoscopy 2020; 52(S 01): S239
DOI: 10.1055/s-0040-1704748
ESGE Days 2020 ePoster Podium presentations
IBD 6 15:00–15:30 Saturday, April 25, 2020 ePoster Podium 8
© Georg Thieme Verlag KG Stuttgart · New York

EFFICIENCY AND SAFETY OF ENDOSCOPIC BALLOON DILATION OF ILEOCOLONIC ANASTOMOTIC STRICTURES IN PATIENTS WITH CROHN´S DISEASE: A MULTICENTRIC RETROSPECTIVE STUDY

M Lukas
1   ISCARE I.V.F. a.s., IBD Clinical and Research Centre, Prague, Czech Republic
,
M Kolar
1   ISCARE I.V.F. a.s., IBD Clinical and Research Centre, Prague, Czech Republic
,
M Vasatko
1   ISCARE I.V.F. a.s., IBD Clinical and Research Centre, Prague, Czech Republic
,
P Klvana
2   Hospital Frydek-Mistek, Beskydy Gastroenterology Center, Department of Internal Medicine, Frydek-Mistek, Czech Republic
,
V Leksa
3   Pardubice Hospital, Endoscopy, Internal Department, Pardubice, Czech Republic
,
J Dyntr
4   Krajska zdravotni, a.s., Masaryk Hospital Usti nad Labem, Gastroenterology, Usti nad Labem, Czech Republic
,
L Baca
5   Vitkovice Hospital, Digestive Diseases Center, Ostrava, Czech Republic
,
B Pipek
5   Vitkovice Hospital, Digestive Diseases Center, Ostrava, Czech Republic
,
B Bahnikova
6   Regional Hospital Liberec, Gastroenterology and Hepatology, Liberec, Czech Republic
,
S Summerova
7   Thomayer Hospital and Third Faculty of Medicine, Charles University, Department of Internal Medicine, Prague, Czech Republic
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Ileocolonic resection is common in Crohn´s disease (CD). However, stricture formation in the anastomosis is a frequent cause of morbidity and surgery. Endoscopic balloon dilation (EBD) is an established modality for non-surgical treatment of these strictures, however, summary data from the Czech Republic are lacking.

    Methods All EBDs of CD anastomotic strictures performed in the 7 centers from the Czech Republic between January 2013 and May 2019 were included. Demographics, disease characteristics, concomitant medication and procedure outcomes with associated complications were analyzed. Technical success was defined as an ability to pass the endoscope following the procedure.

    Results In total, 615 procedures performed in 282 patients, 52.1% males, were included. Mean age was 41.9 ± 12.7 years and disease duration 14.5 ± 8.4 years. Single dilation was performed in 47.9% of patients, 52.1% requested repeated interventions (2–10, median 2). Cumulative probability of redilation at 6 months, 1 year and 3 years was 20.2% (95%CI 14.8–26.2%), 31.8% (95%CI 26.5–37.2%) and 59.4% (95%CI 55.5–63.0%), respectively. Cumulative probabilities of a need for reoperation were 4.4% (95%CI 0.5–16.9%), 8.2% (95%CI 2.3–19.3%) and 14.8% (95%CI 7.1–25.2%), respectively. Technical success was reached in 81.1% of procedures and relief of symptoms in 86.7%. Success of the procedure was dependent on age (OR 0.98; 95%CI 0.96–0.99), smoking (OR 0.57; 95%CI 0.32–0.98) and concomitant immunosuppression (OR 1.99; 95%CI 1.31–3.02). Complications occurred in 2.6% of the procedures. Reintervention until 6 months after the procedure was needed in 26.7% of cases, out of which repeated dilation in 21.3% and surgery in 5.4%. The technical success (OR 0.44; 95%CI 0.29–0.67) and repeated dilation (OR 1.57; 95%CI 1.09–2.27) were associated with the need for reintervention until 6 months.

    Conclusions In a large multicentric Czech cohort, the EBD in CD anastomotic strictures was proven to be safe and effective with results comparable to the available international data.


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