Brendan P Halloran, Matthew Reeson, Christopher Teshima, Karen Kroeker, Vivian Huang, Levinus Dieleman, Peter Holmes, Daniel C Baumgart, Karen Wong, Frank Hoentjen, Farhad Peerani, Sergio Zepeda-Gomez
{"title":"在克罗恩病中通过球囊辅助内镜扩张狭窄:单球囊和双球囊系统的方法和术中结果。","authors":"Brendan P Halloran, Matthew Reeson, Christopher Teshima, Karen Kroeker, Vivian Huang, Levinus Dieleman, Peter Holmes, Daniel C Baumgart, Karen Wong, Frank Hoentjen, Farhad Peerani, Sergio Zepeda-Gomez","doi":"10.1177/17562848241230904","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Despite recent emerging literature involving the utility of endoscopic balloon dilation (EBD) of strictures <i>via</i> balloon-assisted endoscopy (BAE), specifically regarding the management of Crohn's disease (CD), the optimal clinical approach with balloon systems has been largely neglected in academic literature.</p><p><strong>Objectives: </strong>This study assesses the intra-procedural success and safety of EBD <i>via</i> BAE for small bowel CD strictures while detailing our clinical approach and technique. Secondarily, we compare the single-balloon endoscope (SBE) and double-balloon endoscope (DBE) systems for EBD-related outcomes.</p><p><strong>Design: </strong>Retrospective consecutive patient cohort analysis.</p><p><strong>Methods: </strong>We retrospectively assessed a consecutive small bowel CD patient cohort undergoing BAE at the University of Alberta Hospital endoscopy unit from 2013 to 2020. The primary endpoint discerned the safety and immediate success rate of EBD during endoscopy, and comparisons of the dilation parameters and efficacy of SBE <i>versus</i> DBE were assessed as secondary outcomes.</p><p><strong>Results: </strong>During the study period, 87 patients (44 male) with a mean age of 56 ± 14.7 years underwent 179 endoscopic procedures (92 DBE and 87 SBE). Of 358 strictures encountered, 320 (89.4%) were successfully dilated and traversed. The mean maximum dilation diameter was 15.76 ± 2.10 mm. There were no perforations or major adverse events.</p><p><strong>Conclusion: </strong>EBD <i>via</i> BAE is a safe procedure in small bowel CD with a high intraprocedural success rate. Overall, SBE had a higher success rate in traversing strictures before and after dilation using our technique. This analysis is limited by the retrospective nature of our study and must be balanced against the inherent benefits of the DBE system.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"17 ","pages":"17562848241230904"},"PeriodicalIF":3.9000,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903206/pdf/","citationCount":"0","resultStr":"{\"title\":\"Stricture dilation <i>via</i> balloon-assisted endoscopy in Crohn's disease: approach and intraprocedural outcomes with the single-balloon and double-balloon systems.\",\"authors\":\"Brendan P Halloran, Matthew Reeson, Christopher Teshima, Karen Kroeker, Vivian Huang, Levinus Dieleman, Peter Holmes, Daniel C Baumgart, Karen Wong, Frank Hoentjen, Farhad Peerani, Sergio Zepeda-Gomez\",\"doi\":\"10.1177/17562848241230904\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Despite recent emerging literature involving the utility of endoscopic balloon dilation (EBD) of strictures <i>via</i> balloon-assisted endoscopy (BAE), specifically regarding the management of Crohn's disease (CD), the optimal clinical approach with balloon systems has been largely neglected in academic literature.</p><p><strong>Objectives: </strong>This study assesses the intra-procedural success and safety of EBD <i>via</i> BAE for small bowel CD strictures while detailing our clinical approach and technique. Secondarily, we compare the single-balloon endoscope (SBE) and double-balloon endoscope (DBE) systems for EBD-related outcomes.</p><p><strong>Design: </strong>Retrospective consecutive patient cohort analysis.</p><p><strong>Methods: </strong>We retrospectively assessed a consecutive small bowel CD patient cohort undergoing BAE at the University of Alberta Hospital endoscopy unit from 2013 to 2020. The primary endpoint discerned the safety and immediate success rate of EBD during endoscopy, and comparisons of the dilation parameters and efficacy of SBE <i>versus</i> DBE were assessed as secondary outcomes.</p><p><strong>Results: </strong>During the study period, 87 patients (44 male) with a mean age of 56 ± 14.7 years underwent 179 endoscopic procedures (92 DBE and 87 SBE). Of 358 strictures encountered, 320 (89.4%) were successfully dilated and traversed. The mean maximum dilation diameter was 15.76 ± 2.10 mm. There were no perforations or major adverse events.</p><p><strong>Conclusion: </strong>EBD <i>via</i> BAE is a safe procedure in small bowel CD with a high intraprocedural success rate. Overall, SBE had a higher success rate in traversing strictures before and after dilation using our technique. 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Stricture dilation via balloon-assisted endoscopy in Crohn's disease: approach and intraprocedural outcomes with the single-balloon and double-balloon systems.
Background: Despite recent emerging literature involving the utility of endoscopic balloon dilation (EBD) of strictures via balloon-assisted endoscopy (BAE), specifically regarding the management of Crohn's disease (CD), the optimal clinical approach with balloon systems has been largely neglected in academic literature.
Objectives: This study assesses the intra-procedural success and safety of EBD via BAE for small bowel CD strictures while detailing our clinical approach and technique. Secondarily, we compare the single-balloon endoscope (SBE) and double-balloon endoscope (DBE) systems for EBD-related outcomes.
Methods: We retrospectively assessed a consecutive small bowel CD patient cohort undergoing BAE at the University of Alberta Hospital endoscopy unit from 2013 to 2020. The primary endpoint discerned the safety and immediate success rate of EBD during endoscopy, and comparisons of the dilation parameters and efficacy of SBE versus DBE were assessed as secondary outcomes.
Results: During the study period, 87 patients (44 male) with a mean age of 56 ± 14.7 years underwent 179 endoscopic procedures (92 DBE and 87 SBE). Of 358 strictures encountered, 320 (89.4%) were successfully dilated and traversed. The mean maximum dilation diameter was 15.76 ± 2.10 mm. There were no perforations or major adverse events.
Conclusion: EBD via BAE is a safe procedure in small bowel CD with a high intraprocedural success rate. Overall, SBE had a higher success rate in traversing strictures before and after dilation using our technique. This analysis is limited by the retrospective nature of our study and must be balanced against the inherent benefits of the DBE system.
期刊介绍:
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.