Clinical Practice and Safety of Endoscopic Balloon Dilation for Crohn's Disease-Related Strictures: A Nationwide Claim Database Analysis in Japan.

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Research and Practice Pub Date : 2024-11-14 eCollection Date: 2024-01-01 DOI:10.1155/2024/1291965
Rintaro Moroi, Kunio Tarasawa, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Hisashi Shiga, Shin Hamada, Yoichi Kakuta, Kiyohide Fushimi, Kenji Fujimori, Yoshitaka Kinouchi, Atsushi Masamune
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Abstract

Introduction: Although endoscopic balloon dilation (EBD) is a common therapeutic approach for managing strictures associated with Crohn's disease (CD), the clinical application and complication rates of EBD remain unclear. Methods: We collected admission data for patients who underwent EBD using a nationwide database. We compared EBD outcomes between ileal and colonic strictures, CD and ulcerative colitis, and CD and anastomotic strictures arising from cancer-related surgery. Subsequently, propensity score matching was employed to facilitate comparisons between each group. Results: The median duration of hospital stay was 4 days. Endoscopic hemostasis and urgent surgery rates after EBD for CD-related strictures were considerably low (0.035% and 0.11%, respectively). Most patients with CD underwent only one EBD procedure during a single admission. Although no significant differences in patient backgrounds and severe complications were observed between ileal and colonic stricture in CD, multiple EBD procedures were more commonly performed for ileal strictures than for colonic stricture. Moreover, EBD for ileal stricture was more frequently conducted in high-volume centers than in low-volume centers. Regarding severe complications after EBD, no significant differences were observed between CD-related strictures and ulcerative colitis or anastomotic strictures related to cancer surgery. Conclusion: Our findings support the safe and effective use of EBD for both ileal and colonic strictures associated with CD. The clinical practice and safety outcomes of EBD for CD-related strictures were comparable to those for strictures stemming from other etiologies.

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内镜下球囊扩张治疗克罗恩病相关性狭窄的临床实践与安全性:日本全国索赔数据库分析》。
简介:尽管内镜下球囊扩张术(EBD)是治疗克罗恩病(CD)相关狭窄的常用方法,但其临床应用和并发症发生率仍不明确。方法:我们通过一个全国性数据库收集了接受 EBD 患者的入院数据。我们比较了回肠和结肠狭窄、CD 和溃疡性结肠炎、CD 和癌症相关手术引起的吻合口狭窄之间的 EBD 结果。随后,我们采用了倾向得分匹配法来促进各组之间的比较。研究结果中位住院时间为 4 天。CD 相关狭窄的 EBD 术后内镜止血率和紧急手术率相当低(分别为 0.035% 和 0.11%)。大多数 CD 患者在一次入院期间只接受了一次 EBD 手术。虽然 CD 患者的回肠和结肠狭窄在患者背景和严重并发症方面没有明显差异,但回肠狭窄比结肠狭窄更常进行多次 EBD 手术。此外,高流量中心比低流量中心更常对回肠狭窄进行 EBD。关于 EBD 后的严重并发症,CD 相关狭窄与溃疡性结肠炎或癌症手术相关吻合口狭窄之间没有明显差异。结论:我们的研究结果支持对与 CD 相关的回肠和结肠狭窄安全有效地使用 EBD。EBD 用于 CD 相关狭窄的临床实践和安全性结果与用于其他病因引起的狭窄的临床实践和安全性结果相当。
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来源期刊
Gastroenterology Research and Practice
Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
0.00%
发文量
91
审稿时长
1 months
期刊介绍: Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.
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