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Scand J Gastroenterol ; 58(6): 671-679, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36533307

RESUMO

OBJECTIVE: Endoscopic balloon dilatation (EBD) is a standard treatment for intestinal strictures in Crohn's disease (CD). No evidence-based guidelines exist regarding the balloon diameter or the balloon pressure to be used, with recent studies suggesting the use of a smaller diameter than classically used. We sought to analyze the factors associated with safety and efficacy of EBD in CD strictures, particularly looking at balloon diameter and dilatation pressure. METHODS: We conducted a monocentric retrospective study of patients who underwent EBD between 2005 and 2020. RESULTS: Our endoscopy department performed EBD in 94 CD patients during the considered period. The mean size of balloon dilatation was 16 mm (±2.5; including 21 patients with balloon <14 mm) and the mean dilatation pressure was 5.3 atm (±1.5). No perforation was observed. Over a median follow-up of 5.6 years, the probability of being operated was 5.4% at 1 year and 10.4% at 3 years. Smaller height (HR = 0.90, p = 0.022) and a higher BMI (HR = 1.23, p = 0.014) were associated with the risk of operation. The probability of being operated or redilated was 30.1% at 1 year and 52.5% at 3 years. No factor was significantly associated with this risk. The size of the balloon had no impact on outcomes. CONCLUSION: In this retrospective cohort, including a significant proportion of CD patients dilated with balloon <14 mm, no perforation was observed and the size of the balloon or the dilatation pressure had no impact on the risk of surgery or redilatation.


Assuntos
Constrição Patológica , Doença de Crohn , Dilatação , Endoscopia Gastrointestinal , Humanos , Doença de Crohn/complicações , Doença de Crohn/terapia , Constrição Patológica/etiologia , Constrição Patológica/cirurgia , Dilatação/efeitos adversos , Balão Gástrico , Resultado do Tratamento , Estudos Retrospectivos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade
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