Endoscopic balloon dilation is safe, provides longer symptom-free survival in CD stenosis

March 15, 2022

1 minute read


Disclosures: Loras does not report any relevant financial information. Please see the study for relevant financial information from all other authors.

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According to a study published in The Lancet Gastroenterology and Hepatology.

“Our results suggest that [endoscopic balloon dilation (EBD)] is more efficient than [fully covered self-expandable metal stents for Crohn’s disease strictures (FCSEMS)]with fewer patients in the EBD group requiring intervention for symptomatic recurrence at 1 year than in the FCSEMS group, with an equally good safety profile,” Carme LorasPhD, from the University of Barcelona, ​​and his colleagues wrote.

Longer symptom-free survival in patients with Crohn's disease strictures after: endoscopic balloon dilation;  80% VS Fully covered self-expanding metal stents;  51%

Loras and colleagues conducted a multicenter randomized trial of 80 CD patients in Spain with obstructive symptoms and predominantly fibrous strictures less than 10 cm in length. Participants received either EBD with a CRE Boston Scientific pneumatic balloon or FCSEMS with placement of a 20 mm Taewoong metal stent.

The efficacy of each treatment was determined by the proportion of patients who had no further therapeutic intervention, including EBD, FCSEMS, or surgery, due to symptomatic recurrence at 1 year. Secondary outcomes included symptom-free survival, safety, and mean costs.

Thirty-nine patients (mean age, 43 years; 59% female) received FCSEMS and 41 patients (mean age, 47 years; 39% female) received EBD. At 1-year follow-up, 80% of patients in the EBD group were intervention-free due to symptomatic recurrence versus 51% of patients in the FCSEMS group (OR = 3.9; 95% CI, 1.4- 10.6; P = 0.0061). Additionally, 80% of patients in the EBD group had longer symptom-free survival compared to 51% in the FCSEMS group (HR=0.32; 95% CI, 0.14-0.73; P = 0.0043). Five adverse events were recorded, two of which were perforations (one from each group).

Additionally, the analysis revealed that the average cost of treatment was lower per patient in the EBD group compared to the FCSEMS group.

“Our data suggest that EBD should be the first choice for the endoscopic treatment of Crohn’s disease strictures,” Loras and colleagues concluded.

Jack L. Goldstein