Endoscopic stricturotomy in the treatment of anastomotic strictures in inflammatory bowel disease (IBD) and non-IBD patients. (21st October 2019)

• Record Type: Journal Article
• Authors: Zhang, Long-Juan; Lan, Nan; Wu, Xian-Rui; Shen, Bo
• Is Part Of: Gastroenterology report. Volume 8:Number 2(2020)
• Page Start: 143
• Page End: 150
• Publication Date: 2019-10-21
• Subjects: endoscopic stricturotomy -- inflammatory bowel disease -- anastomotic stricture; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1093/gastro/goz051
• Languages: English
• ISSNs: 2052-0034

Abstract

Abstract: Backgrounds: Endoscopic stricturotomy (ESt) has been shown to be effective in treating inflammatory bowel disease (IBD)-associated anastomotic strictures. However, the outcome of ESt in benign, non-IBD conditions has not been described. The aim of this study was to evaluate the outcome of ESt in the management of IBD and non-IBD-associated strictures. Methods: Data of all consecutive IBD and non-IBD patients with benign anastomotic strictures treated with ESt from 2009 to 2016 were extracted. The primary outcomes were surgery-free survival and procedure-related complications. Results: A total of 49 IBD and 15 non-IBD patients were included in this study. The IBD group included 25 patients with Crohn's disease and 24 with ulcerative colitis and ileal pouches. Underlying diseases in the non-IBD group included colorectal cancer ( n = 7), diverticulitis ( n = 5), large bowel prolapse ( n = 2), and constipation ( n = 1). Immediate technical success was achieved in all patients in both groups. Bleeding complications occurred on five occasions (4.7% per procedure) in the IBD group, while no complication occurred in the non-IBD group ( P = 0.20). Stricture improvement on follow-up endoscopy was found in 10 (20.4%) and 5 (33.3%) patients in the IBD and non-IBD groups, respectively ( P = 0.32). Six (12.2%) patients in the IBD group and four (26.7%) patients in the non-IBD group eventually required stricture-related surgery ( P = 0.23). IBD patients appeared to have a higher tendency for maintaining surgery-free after the procedure than non-IBD patients ( P = 0.08). Conclusions: Endoscopic stricturotomy was shown to have comparable outcomes, though non-IBD patients seem to have a higher need for subsequent surgery but a lower complication rate than IBD patients.