Gastroenterologie clinique et biologique · 2003
[Efficacy of hydrostatic balloon dilatation of anastomotic Crohn's disease strictures].
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Blanchet Eloi, Beau Philippe
Аннотация
OBJECTIVES: To estimate the efficacy of hydrostatic balloon dilatation (HD) of anastomotic strictures of Crohn's disease and the impact of medical treatment on the duration of HD effects.
METHODS: Sixteen patients with anastomotic stricture (average length: 4.7 cm) were treated by HD and followed-up for a median duration of 24 months. Immunosuppressive treatment was given when a second HD was necessary.
RESULTS: HD failed in 3 patients (19%). Thirty-two HD are performed in the other 13 (1 HD: 6; 2 HD: 2; > 2 HD: 5). No severe complication was observed. Eight patients received immunosuppressive treatment started before the first HD in 4 cases or following the second HD in 4 cases. Based on actuarial analysis, clinical and surgical recurrence rates were 39% and 0% at 1 year and 73% and 12% at 2 years, respectively. Time between the first and the second HD were not statistically different (P=0.24) for HD performed with (11.5 +/- 8.8 months; range: 5-30) or without (8.0 +/- 6.9 months; range: 2-17) immunosuppressive treatment.
CONCLUSION: HD delays the surgical timing for anastomotic Crohn's disease strictures. Medical treatment associated with HD does not seem to modify the duration of the clinical remission.
METHODS: Sixteen patients with anastomotic stricture (average length: 4.7 cm) were treated by HD and followed-up for a median duration of 24 months. Immunosuppressive treatment was given when a second HD was necessary.
RESULTS: HD failed in 3 patients (19%). Thirty-two HD are performed in the other 13 (1 HD: 6; 2 HD: 2; > 2 HD: 5). No severe complication was observed. Eight patients received immunosuppressive treatment started before the first HD in 4 cases or following the second HD in 4 cases. Based on actuarial analysis, clinical and surgical recurrence rates were 39% and 0% at 1 year and 73% and 12% at 2 years, respectively. Time between the first and the second HD were not statistically different (P=0.24) for HD performed with (11.5 +/- 8.8 months; range: 5-30) or without (8.0 +/- 6.9 months; range: 2-17) immunosuppressive treatment.
CONCLUSION: HD delays the surgical timing for anastomotic Crohn's disease strictures. Medical treatment associated with HD does not seem to modify the duration of the clinical remission.