Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2017; 23(41): 7397-7406
Published online Nov 7, 2017. doi: 10.3748/wjg.v23.i41.7397
Endoscopic balloon dilation of Crohn’s disease strictures-safety, efficacy and clinical impact
Susana Lopes, Eduardo Rodrigues-Pinto, Patrícia Andrade, Joana Afonso, Todd H Baron, Fernando Magro, Guilherme Macedo
Susana Lopes, Eduardo Rodrigues-Pinto, Patrícia Andrade, Fernando Magro, Guilherme Macedo, Gastroenterology Department, Faculty of Medicine, Hospital de São João, Porto 4200-319, Portugal
Joana Afonso, Fernando Magro, Department of Pharmacology and Therapeutics, University of Porto, Porto 4200-319, Portugal
Todd H Baron, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC 4200, United States
Author contributions: Lopes S and Rodrigues-Pinto E contributed equally in the design, conception, analysis, and paper writing; Lopes S, Rodrigues-Pinto E and Magro F conceived and designed the study; Lopes S, Rodrigues-Pinto E and Andrade P collected and analyzed the data; Afonso J performed all laboratorial procedures; Rodrigues-Pinto E and Andrade P were responsible for statistical analysis; Baron TH, Magro F and Macedo G participated in critical revision of the manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of Centro Hospitalar São João, Porto, Portugal.
Informed consent statement: All patients gave informed written consent to participate in the study.
Conflict-of-interest statement: The authors of this manuscript have no conflict of interest to declare.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guilherme Macedo MD, PhD, Department of Gastroenterology, Centro Hospitalar São João, Alameda Professor Hernani Monteiro, Porto 4200-319, Portugal. guilhermemacedo59@gmail.com
Telephone: +351-22-5513600 Fax: +351-22-5513601
Received: August 16, 2017
Peer-review started: August 19, 2017
First decision: August 30, 2017
Revised: September 11, 2017
Accepted: September 20, 2017
Article in press: September 19, 2017
Published online: November 7, 2017
Core Tip

Core tip: This study evaluated the incidence of anastomotic strictures after intestinal resection in Crohn’s disease (CD), the long-term efficacy and safety of endoscopic balloon dilation (EBD) in CD strictures and its impact on the diagnosis of subclinical postoperative endoscopic recurrence. Almost one-third of CD patients developed an anastomotic stricture after ileocecal resection/right hemicolectomy. EBD was an effective and safe alternative to surgery, with a good short and long-term outcome, postponing or even avoiding further surgery. EBD also allowed to diagnose disease recurrence in patients with no clinical signs/biomarkers of disease activity. Longer intervals after surgery and higher lactoferrin levels were associated with anastomotic strictures; time until dilation was lower in patients with calprotectin levels > 83.35 μg/g and current/past history of smoking.