title: Endoscopic balloon dilation for stenotic lesions in Crohn's disease.
abstract: OBJECTIVE
  Endoscopic balloon dilation (EBD) can serve as an alternative to surgery for intestinal stenosis associated with Crohn's disease (CD). However, there has been controversy regarding the efficacy and safety of EBD. Here we sought to determine the therapeutic efficacy and safety of EBD for intestinal stenosis in CD.
  
  
  METHODS
  Of 43 patients with CD accompanied by intestinal stenosis, 30 underwent EBD. These 30 patients were examined retrospectively in terms of the scope passage rate, surgery-free rate, and whether or not the observation of the distal intestinal tract influenced the therapeutic strategy.
  
  
  RESULTS
  The overall scope passage and surgery-free rates were 90.0% and 76.7%, respectively. There were no statistically significant differences in the site of the dilated intestinal tract among groups. Patients who had inflammation in the distal intestinal tract alone after EBD accounted for 56.7%. The rate of re-dilation was 46.7%, and time until re-dilation was 6.6±3.6 months.
  
  
  CONCLUSIONS
  EBD was associated with favorable short-term and long-term outcomes and good safety. Observation of the distal intestinal tract influenced the decision-making process for therapeutic strategies. The results of this study suggest that EBD may allow the postponement or even avoidance of surgery, enabling not only intestinal dilation but also the evaluation of mucosal healing to be performed. Thus, EBD is considered to be an effective alternative treatment for intestinal stenotic lesions in patients with CD.
authors.affiliation: Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan. t-sugaya@dokkyomed.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugaya
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tominaga
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Takahashi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takenaka
authors.forename: Atushi
authors.initials: A
authors.lastname: Hoshino
authors.forename: Takero
authors.initials: T
authors.lastname: Koike
authors.forename: Masakazu
authors.initials: M
authors.lastname: Nakano
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hiraishi
mesh_terms: D000328:Adult; D000071087:Balloon Enteroscopy / Q000379:methods*; D003251:Constriction, Pathologic / Q000601:surgery; D003424:Crohn Disease / Q000473:pathology / Q000601:surgery*; D004106:Dilatation / Q000379:methods*; D005260:Female; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome