A nationwide, multi-center, retrospective study of symptomatic small bowel stricture in patients with Crohn's disease
| Autor: | Norimasa Fukata, Manabu Ishii, Shin Fujioka, Toshihiro Inokuchi, Kazuki Kakimoto, Kei Moriya, Hidetoshi Takedatsu, Masaki Yamashita, Kento Takenaka, Shinta Mizuno, Keiji Ozeki, Taku Kobayashi, Yu Nishida, Teruyuki Takeda, Ryosuke Sakemi, Akira Sonoda, Kyouko Yoshioka, Toshio Shimokawa, Kazuya Kitamura, Hiroki Tanaka, Tetsu Kinjo, Shinya Ashizuka, Toshimitsu Fujii, Toshifumi Hibi, Yuichi Shimodate, Hiroki Kitamoto, Fumiaki Takahashi, Shigeki Bamba, Makoto Ooi, Shinichiro Shinzaki, Ryohei Hayashi, Ryo Ozaki, Akira Andoh, Akihiro Yamada, Hirotake Sakuraba, Shotaro Umezawa |
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| Rok vydání: | 2019 |
| Předmět: |
Enteroscopy
Adult Male medicine.medical_specialty Balloon Enteroscopy Time Factors Balloon enteroscope Constriction Pathologic Inflammatory bowel disease 03 medical and health sciences 0302 clinical medicine Maintenance therapy Crohn Disease Intestine Small medicine Humans Immunologic Factors Retrospective Studies Stenosis Crohn's disease business.industry Gastroenterology Retrospective cohort study Endoscopy medicine.disease Colorectal surgery Surgery Treatment Outcome 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Smoking Cessation Tumor Necrosis Factor Inhibitors business Intestinal Obstruction Abdominal surgery |
| Zdroj: | Journal of gastroenterology. 55(6) |
| ISSN: | 1435-5922 |
| Popis: | BACKGROUND:Small bowel stricture is one of the most common complications in patients with Crohn's disease (CD). Endoscopic balloon dilatation (EBD) is a minimally invasive treatment intended to avoid surgery; however, whether EBD prevents subsequent surgery remains unclear. We aimed to reveal the factors contributing to surgery in patients with small bowel stricture and the factors associated with subsequent surgery after initial EBD. METHODS:Data were retrospectively collected from surgically untreated CD patients who developed symptomatic small bowel stricture after 2008 when the use of balloon-assisted enteroscopy and maintenance therapy with anti-tumor necrosis factor (TNF) became available. RESULTS:A total of 305 cases from 32 tertiary referral centers were enrolled. Cumulative surgery-free survival was 74.0% at 1 year, 54.4% at 5 years, and 44.3% at 10 years. The factors associated with avoiding surgery were non-stricturing, non-penetrating disease at onset, mild severity of symptoms, successful EBD, stricture length CONCLUSIONS:In CD patients with symptomatic small bowel stricture, addition of immunomodulator or anti-TNF and smoking cessation may improve the outcome of symptomatic small bowel stricture, by avoiding frequent EBD and subsequent surgery after initial EBD. |
| Databáze: | OpenAIRE |
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