title: Efficacy and safety of endoscopic balloon dilation for Crohn's strictures.
abstract: OBJECTIVE
  This study was designed to investigate retrospectively the efficacy and safety of endoscopic balloon dilation for intestinal strictures in Crohn's disease.
  
  
  METHODS
  Sixteen patients with 20 strictures were treated. The stricture sites were as follows: at the ileocolonic (n = 6) or ileoileal (n = 1) anastomosis, in the colon (n = 10), ileum (n = 2), and at the ileocecal valve (n = 1). The dilations were performed with through-the-scope balloons, with diameters of 15 to 20 mm on inflation and lengths of 30 to 80 mm.
  
  
  RESULTS
  In 15 of 16 patients, the strictures were successfully dilated and the symptoms caused by the strictures disappeared after the first session. The patients were followed for a median of 38.5 months. Repeat symptomatic stricture formation occurred after a mean of 19.7 months in seven patients. Four patients needed second-round dilation and three patients were treated surgically. Complications occurred in four patients who had primary strictures: bleeding in one, high fever in one, and colorectal perforation in two. One of the patients complicated with colorectal perforation was treated surgically, and the other was treated conservatively. The cumulative nonsurgical rates for the dilation strictures were 93 percent at 12 months and 65 percent at 36 months, respectively. Three patients were treated surgically because of strictures or fistulas that were not related to the procedure of dilation. As a whole, the cumulative nonsurgical rates were 81 percent at 12 months and 46 percent at 36 months. Nine patients (56.3 percent) were able to avoid surgery.
  
  
  CONCLUSIONS
  Using endoscopic balloon dilation, it may be possible to avoid or postpone surgery. Primary strictures seem to have increased risk of perforation.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. enomura@int3.med.tohoku.ac.jp
authors.forename: Eiki
authors.initials: E
authors.lastname: Nomura
authors.forename: Sho
authors.initials: S
authors.lastname: Takagi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Negoro
authors.forename: Seiichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kinouchi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hiwatashi
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods*; D003424:Crohn Disease / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome