Biologic therapy does not affect results of endoscopic balloon dilations in Crohn's disease patients
Abstract
Patients with Crohn's disease are at substantial risk of recurrent stenotic complications even after they have been operated on. Endoscopic balloon dilation is an acceptable alternative to surgical therapy in selected cases.
Methods: We performed a retrospective analysis of results of endoscopic balloon dilations in patients with Crohn's disease treated in our center. The aim was to assess the efficacy and safety of the balloon dilation as well as the influence of bio-logic therapy and other factors on results of dilation therapy.
Results: Between May 2007 and December 2013 we performed 220 balloon dilations on 109 Crohn's disease patients. Technical success (passage through the stricture after dilation) was achieved in 77% and clinical efficacy in 75% of cases.
Technical success was associated with significantly longer duration of clinical effect (10 months vs 4.5 months, p < 0.001), and lower risk of surgery (14% vs 29%; p = 0.02). Dilation of anastomotic strictures was also associated with more favorable outcome with respect to the risk of surgery as compared with primary stenosis (11% vs 42%; p < 0.001).
Concomitant bio-logic therapy did not have any effect on clinical effect of dilation and the risk of surgery was also not affected by this treatment. Serious complications were observed in 2% of cases (three cases of bleeding and one perforation).
Conclusion: Balloon dilation is an effective and safe therapeutic method especially in patients with anastomotic strictures. Technical success prolongs clinical efficacy and decreases the risk of surgery.
Biological therapy has no effect on the results of dilation therapy.