Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures
Abstract Background Endoscopic balloon dilation (EBD) is an effective, minimally invasive treatment for Crohn's disease (CD) related intestinal strictures. However, restenosis frequently occurs and requires repetitive EBD or surgical resection. Since previous studies could not evaluate restenos...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | DEN Open |
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| Online Access: | https://doi.org/10.1002/deo2.239 |
| _version_ | 1797837230584102912 |
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| author | Ulzii Dashnyam Manabu Nagayama Tomonori Yano Hirotsugu Sakamoto Makiko Mieno Jun Owada Kunihiko Oguro Tsevelnorov Khurelbaatar Keijiro Sunada Alan Kawarai Lefor Hironori Yamamoto |
| author_facet | Ulzii Dashnyam Manabu Nagayama Tomonori Yano Hirotsugu Sakamoto Makiko Mieno Jun Owada Kunihiko Oguro Tsevelnorov Khurelbaatar Keijiro Sunada Alan Kawarai Lefor Hironori Yamamoto |
| author_sort | Ulzii Dashnyam |
| collection | DOAJ |
| description | Abstract Background Endoscopic balloon dilation (EBD) is an effective, minimally invasive treatment for Crohn's disease (CD) related intestinal strictures. However, restenosis frequently occurs and requires repetitive EBD or surgical resection. Since previous studies could not evaluate restenosis based on stricture diameter, factors affecting restenosis after EBD were unclear. This study aimed to identify these factors by precisely measuring the diameter of small intestinal strictures in patients with CD. Methods This single‐center retrospective study enrolled patients with CD with de novo small intestinal strictures who underwent two double‐balloon enteroscopy sessions (EBD and follow‐up) between January 2016 and October 2021. Clinical and endoscopic data were obtained from electronic medical records. A calibrated small‐caliber‐tip transparent hood was used to precisely measure stricture diameters. Multivariate analysis was performed to identify factors associated with restenosis. Results Forty‐eight patients (37 male) were analyzed. The total number of strictures detected decreased from 162 to 143. The mean diameter of all strictures and the narrowest stricture in each patient increased significantly from 8.6 to 9.8 mm and from 7.6 to 8.7 mm, respectively. Thirty‐two (67%) patients developed endoscopic restenosis. Multivariate analysis showed that the presence of ulcers at the follow‐up session was a risk factor for restenosis (odds ratio 9.4, p = 0.01). Patients with complete mucosal healing at both sessions (n = 21) showed significant improvement in the narrowest stricture (+1.7 mm, p = 0.001). Conclusions Maintenance of complete mucosal healing is significantly associated with avoiding restenosis after EBD in CD‐related small intestinal strictures. |
| first_indexed | 2024-04-09T15:22:33Z |
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| id | doaj.art-69f1528b139d436fa23dc4d8c18d1b66 |
| institution | Directory Open Access Journal |
| issn | 2692-4609 |
| language | English |
| last_indexed | 2024-04-09T15:22:33Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj.art-69f1528b139d436fa23dc4d8c18d1b662023-04-29T05:12:57ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.239Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal stricturesUlzii Dashnyam0Manabu Nagayama1Tomonori Yano2Hirotsugu Sakamoto3Makiko Mieno4Jun Owada5Kunihiko Oguro6Tsevelnorov Khurelbaatar7Keijiro Sunada8Alan Kawarai Lefor9Hironori Yamamoto10Department of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medical Informatics Center for Information Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Surgery Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanAbstract Background Endoscopic balloon dilation (EBD) is an effective, minimally invasive treatment for Crohn's disease (CD) related intestinal strictures. However, restenosis frequently occurs and requires repetitive EBD or surgical resection. Since previous studies could not evaluate restenosis based on stricture diameter, factors affecting restenosis after EBD were unclear. This study aimed to identify these factors by precisely measuring the diameter of small intestinal strictures in patients with CD. Methods This single‐center retrospective study enrolled patients with CD with de novo small intestinal strictures who underwent two double‐balloon enteroscopy sessions (EBD and follow‐up) between January 2016 and October 2021. Clinical and endoscopic data were obtained from electronic medical records. A calibrated small‐caliber‐tip transparent hood was used to precisely measure stricture diameters. Multivariate analysis was performed to identify factors associated with restenosis. Results Forty‐eight patients (37 male) were analyzed. The total number of strictures detected decreased from 162 to 143. The mean diameter of all strictures and the narrowest stricture in each patient increased significantly from 8.6 to 9.8 mm and from 7.6 to 8.7 mm, respectively. Thirty‐two (67%) patients developed endoscopic restenosis. Multivariate analysis showed that the presence of ulcers at the follow‐up session was a risk factor for restenosis (odds ratio 9.4, p = 0.01). Patients with complete mucosal healing at both sessions (n = 21) showed significant improvement in the narrowest stricture (+1.7 mm, p = 0.001). Conclusions Maintenance of complete mucosal healing is significantly associated with avoiding restenosis after EBD in CD‐related small intestinal strictures.https://doi.org/10.1002/deo2.239calibrated small‐caliber‐tip transparent hoodCrohn's diseasedouble‐balloon enteroscopyendoscopic balloon dilationendoscopic restenosis |
| spellingShingle | Ulzii Dashnyam Manabu Nagayama Tomonori Yano Hirotsugu Sakamoto Makiko Mieno Jun Owada Kunihiko Oguro Tsevelnorov Khurelbaatar Keijiro Sunada Alan Kawarai Lefor Hironori Yamamoto Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures DEN Open calibrated small‐caliber‐tip transparent hood Crohn's disease double‐balloon enteroscopy endoscopic balloon dilation endoscopic restenosis |
| title | Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures |
| title_full | Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures |
| title_fullStr | Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures |
| title_full_unstemmed | Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures |
| title_short | Maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of Crohn's disease‐related small intestinal strictures |
| title_sort | maintenance of complete mucosal healing is associated with avoiding restenosis after endoscopic balloon dilation of crohn s disease related small intestinal strictures |
| topic | calibrated small‐caliber‐tip transparent hood Crohn's disease double‐balloon enteroscopy endoscopic balloon dilation endoscopic restenosis |
| url | https://doi.org/10.1002/deo2.239 |
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