A novel endoscopic dilation for benign stenosis of the small intestine, using radial incision and cutting method.

Background and aim: Benign stenosis of the small intestine is developed by several causes including mucosal healing of inflammatory bowel diseases, after surgery, and side effect of NSAIDs. We have been conducting a clinical trial using radial incision and cutting (RIC) method instead of balloon dilation for benign stenosis of lower gastrointestinal tract. We aimed to investigate the feasibility and safety of RIC for small intestine.
Method: This is a multicenter prospective interventional study registered in UMIN. We analyzed part of the data of this trial.
Results: We performed six RIC procedures for benign stenosis of the small intestine in five patients with Crohn’s disease. We performed RIC for four cases with terminal ileum lesion using a colonoscope and ITknife nano®. We also performed RIC for one case with middle ileum lesion using a double-balloon endoscopy and a long-length snare. The technical success (scope passage) rate was 100%. One case developed delayed bleeding and endoscopic hemostasis was performed.
Discussion: We could perform RIC for the terminal ileum stenosis as well as colonic stenosis.
Further studies are warranted to investigate the feasibility and safety of RIC for the small intestine. We have rcently registered a clinical trial of RIC for jejunum and ileum using a long-length electric device which is not approved in Japan (registered in jRCT) and will enroll patients.