Hydrostatic balloon dilatation of Crohn's strictures.
OBJECTIVE
To evaluate the safety and long-term efficacy of per-endoscopic hydrostatic balloon dilatation in a retrospective series of patients with Crohn's disease.


METHODS
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).


RESULTS
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.


CONCLUSIONS
Hydrostatic balloon dilatation is effective for Crohn's symptomatic strictures, and can avoid or postpone surgery, with an acceptable rate of complications.
Sabaté
J-M
JM
Department of Gastroenterology, Hôpital Saint-Louis, Paris, France.
Villarejo
J
J
Bouhnik
Y
Y
Allez
M
M
Gornet
J-M
JM
Vahedi
K
K
Modigliani
R
R
Lémann
M
M
D000328:Adult; D002404:Catheterization / Q000379:methods*; D003424:Crohn Disease / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D016896:Treatment Outcome