| Endoscopic balloon dilation (EBD) has been established as a therapeutic option for Crohn’s strictures. It has been adapted mainly for upper GI, colon, rectum and anastomosis site after ileo-cecal resection. However, in this decade, EBD using balloon-assited enteroscopy has been utilized for small bowel stricture of CD. Therefore, we can perform EBD for any gastrointestinal tracts. Although almost all reports regarding the efficacy and safety of EBD were retrospective study, we reported the efficacy of EBD for small bowel stricture in CD patients as a nationwide, multi-center, prospective study. According to this study, procedure failure occurred in 6 cases (6.3%) in 95 subjects and short-term symptomatic improvement was achieved in 66 patients (69.5%). Adverse events were only seen in 5 patients (5%). Subsequent long-term outcome were analyzed by investigating cumulative surgery-free rate and re-dilation free rate. Cumulative surgical free rates were 88.8%, 84.1% at 1 and 2 years after EBD. Re-dilation free survival were 65.8%, 45.2% at 1 and 2 years after EBD. It is considered that EBD enable CD patients with bowel stricture to avoid the surgery, however, need for re-dilation was an issue of this treatment. In general, EBD for bowel strictures in CD is useful and safe treatment. However, strategy for resolution of symptomatic relapse such as anti-fibrotic therapy should be established in the future. |
