[Efficacy of hydrostatic balloon dilatation of anastomotic Crohn's disease strictures].

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.