Endoscopic Management of Strictures in Crohn’s Disease: An Unsolved Case
Abstract
:1. Introduction
2. Methods
3. Endoscopic Balloon Dilation
3.1. Endoscopic Balloon Dilation as the Standard Endoscopic Procedure for Short Strictures in Crohn’s Disease
3.2. Intralesional Corticosteroid Injection
3.3. Endoscopic Balloon Dilation in the Upper Gastrointestinal Tract
3.4. Focus on Dilation during Enteroscopy, a Stand-Alone Situation?
4. Endoscopic Electroincision: Stricturotomy and Strictureplasty
5. The Graveyard of Endoscopic Techniques: Is There Room for a Second Chance?
5.1. Anti-TNF Intralesional Injection
5.2. Self-Expanding Metal Stents
5.3. Lumen-Apposing Metal Stents
5.4. Biodegradable Stents
6. New Techniques and Future Scenarios for Stenosis and Fibrosis Treatment in IBD Involving Pathogenesis and Molecular Pathways
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Study Design | Strictures Location | Treatment and No of Pts | Technical Success Rate | Long-Term Outcomes (Years fu) | Adverse Events, % | |
---|---|---|---|---|---|---|
[17] 2017 | Retrospective | Ileocolic anastomosis | 176 EBD 131 surgery | - | average time to surgery/re-surgery delayed by 6.45 years in EBD group | 1.1 (perforation) 8.8 (~infection) |
[18] 2024 | Retrospective | Duodenal | 30 EBD 18 surgery | - | 2.96 years recurrence-free 6.31 years recurrence-free, p = 0.01 | 0.74 16.67 |
[19] 2018 | Retrospective | Anastomosis (85.7% ileocolic) | 21 ES 164 EBD | 100% 89.5% | 9.5% surgery (0.8) 33.5% re-surgery (4) | 8.8 (bleeding) 1.1 (perforation) |
[20] 2019 | Retrospective | Ileocolic anastomosis | 35 ES 147 ICR | - | 11.3% surgery (0.8) 10.2% re-surgery (2.2), p = 0.83 | 10.2 (~bleeding) 31.9 (~ileus) |
[21] 2020 | Retrospective | Distal ileum, ileocecal valve | 13 ES 32 ICR | 100% 100% | 15.4% surgery (1.8) 18.8% re-surgery (1.5), p = 0.79 | 6,9 (perforation) 25 (~infection) |
[22] 2022 | Randomized trial | - | 41 EBD 39 FCSEMS | - | 80% no re-intervention (1) 51% no re-intervention (1), p = 0.0061 | 2 (perforation) 3 (perforation) |
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Coppola, G.; Principessa, C.; Di Vincenzo, F.; Puca, P.; Del Gaudio, A.; Capobianco, I.; Bartocci, B.; Papa, A.; Cammarota, G.; Lopetuso, L.R.; et al. Endoscopic Management of Strictures in Crohn’s Disease: An Unsolved Case. J. Clin. Med. 2024, 13, 4842. https://doi.org/10.3390/jcm13164842
Coppola G, Principessa C, Di Vincenzo F, Puca P, Del Gaudio A, Capobianco I, Bartocci B, Papa A, Cammarota G, Lopetuso LR, et al. Endoscopic Management of Strictures in Crohn’s Disease: An Unsolved Case. Journal of Clinical Medicine. 2024; 13(16):4842. https://doi.org/10.3390/jcm13164842
Chicago/Turabian StyleCoppola, Gaetano, Chiara Principessa, Federica Di Vincenzo, Pierluigi Puca, Angelo Del Gaudio, Ivan Capobianco, Bianca Bartocci, Alfredo Papa, Giovanni Cammarota, Loris Riccardo Lopetuso, and et al. 2024. "Endoscopic Management of Strictures in Crohn’s Disease: An Unsolved Case" Journal of Clinical Medicine 13, no. 16: 4842. https://doi.org/10.3390/jcm13164842