Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Efficacy of Endoscopic Dilation of gastroduodenal Crohn's disease strictures: A Systematic Review and Meta-analysis of Individual Patient Data

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Effects of Vedolizumab in Patients With Primary Sclerosing Cholangitis and Inflammatory Bowel Diseases

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Incidence of Immune-mediated Inflammatory Diseases Among Patients With Inflammatory Bowel Diseases in Denmark

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Colorectal Cancer in Individuals With Familial Adenomatous Polyposis, Based on Analysis of the Danish Polyposis Registry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Does eradication of Helicobacter pylori cause inflammatory bowel disease?

    Publikation: Bidrag til tidsskriftLederForskningpeer review

  1. Colorectal Cancer in Individuals With Familial Adenomatous Polyposis, Based on Analysis of the Danish Polyposis Registry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Cascade Guideline

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Subtyping of intraductal papillary mucinous neoplasms - pitfalls of MUC1 immunohistochemistry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. A novel endoscopic ultrasound-guided through-the-needle microbiopsy procedure improves diagnosis of pancreatic cystic lesions

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Dominik Bettenworth
  • Marcus M Mücke
  • Rocio Lopez
  • Amandeep Singh
  • Weiming Zhu
  • Feilong Guo
  • Toshiyuki Matsui
  • Theodore W James
  • Hans Herfarth
  • Martin Goetz
  • Ren Mao
  • Satya Kurada
  • Jochen Hampe
  • Katja Matthes
  • John Gásdal Karstensen
  • Piero V Valli
  • Marjolijn Duijvestein
  • Geert D'Haens
  • Vipul Jairath
  • Tian Bai Qiu
  • Nik Sheng Ding
  • Gerhard Rogler
  • Florian Rieder
Vis graf over relationer

BACKGROUND & AIMS: Little is know about the effects of endoscopic balloon dilation (EBD) for strictures of the upper gastrointestinal (UGI) tract in patients with Crohn's disease (CD). We performed a pooled analysis of the efficacy and safety of EBD for UGI CD-associated strictures.

METHODS: We searched the EMBASE, Medline and Cochrane library, as well as bibliographies of relevant articles, for cohort studies of adults with CD and strictures of the stomach, or duodenum (up to the ligament of Treitz) who underwent EBD through December 2016. We obtained data from 7 international referral centers on 94 patients who underwent 141 EBD. We performed a patient-level meta-analysis of data from published and unpublished cohort studies to determine mechanical and clinical success. We performed time to event analysis to assess symptom recurrence and need for re-dilation or surgery. The patients analyzed had strictures of the duodenum (n=107), stomach (n=30), or spanning both (n=4).

RESULTS: The rate of technical success for EBD was 100%, with 87% short term clinical efficacy; major complications arose from 2.9% of all procedures. During median follow up of 23.1 months, 70.5% patients had recurrence of symptoms, 59.6% required re-dilation, and 30.8% required surgical intervention. Patients whose disease was located in the small bowel had a higher risk for symptom recurrence (hazard ratio [HR], 2.1; P=.003). Asian race (HR, 2.8; P<.001) and location of disease in the small bowel (HR, 1.9; P=.004) increased the need for re-dilation. Prestenotic dilation was a risk factor for earlier need for surgery (HR, 1.9; P=.001).

CONCLUSIONS: In a meta-analysis, we found EBD for CD-associated strictures of the UGI to be a effective alternative to surgery, with a high rate of short-term technical and clinical success, moderate long-term efficacy, and an acceptable rate of complications.

OriginalsprogEngelsk
TidsskriftClinical Gastroenterology and Hepatology
Vol/bind17
Udgave nummer12
Sider (fra-til)2514-2522
Antal sider9
ISSN1542-3565
DOI
StatusUdgivet - nov. 2019

ID: 55820761