Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease
Abstract Objectives Endoscopic balloon dilation (EBD) is an effective treatment for intestinal strictures in Crohn's disease (CD). However, restenosis often occurs and requires repeat EBD or surgery. Previous studies have seldom examined restenosis with respect to stricture diameter, leaving th...
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Wiley
2025-04-01
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| Online Access: | https://doi.org/10.1002/deo2.70121 |
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| author | Jun Owada Kunihiko Oguro Tomonori Yano Yusuke Ono Takuma Kobayashi Shoko Miyahara Hirotsugu Sakamoto Hironori Yamamoto |
| author_facet | Jun Owada Kunihiko Oguro Tomonori Yano Yusuke Ono Takuma Kobayashi Shoko Miyahara Hirotsugu Sakamoto Hironori Yamamoto |
| author_sort | Jun Owada |
| collection | DOAJ |
| description | Abstract Objectives Endoscopic balloon dilation (EBD) is an effective treatment for intestinal strictures in Crohn's disease (CD). However, restenosis often occurs and requires repeat EBD or surgery. Previous studies have seldom examined restenosis with respect to stricture diameter, leaving the factors contributing to post‐EBD restenosis unclear. Our retrospective study indicated that complete mucosal healing significantly reduces restenosis after EBD in CD‐related small intestinal strictures. This prospective study aimed to validate these findings by accurately measuring stricture diameters in patients with CD. Methods We conducted a single‐center prospective study of patients with CD and small intestinal strictures. The patients underwent an EBD session between June 2022 and December 2023. Stricture diameters were measured using a calibrated small‐caliber‐tip transparent hood. Multivariate analysis was performed to identify factors influencing stricture progression. Results This study included 41 patients (33 men). The number of strictures detected between sessions increased from 159 to 170. The average diameter of all strictures and the narrowest stricture per patient showed slight increases. However, 73% of patients experienced stricture progression. The presence of ulcers between sessions was identified as a significant risk factor for stricture progression (odds ratio 7.59, p = 0.031). Patients achieving complete mucosal healing demonstrated a significant increase in the narrowest stricture diameter (+1.5 mm, p = 0.00089). Conclusions Complete mucosal healing is crucial for preventing stricture progression after EBD in patients with CD‐related small intestinal strictures. |
| format | Article |
| id | doaj-art-841bc5f024a84ee884ffd320bb2f3450 |
| institution | DOAJ |
| issn | 2692-4609 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
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| spelling | doaj-art-841bc5f024a84ee884ffd320bb2f34502025-08-20T03:13:50ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70121Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's diseaseJun Owada0Kunihiko Oguro1Tomonori Yano2Yusuke Ono3Takuma Kobayashi4Shoko Miyahara5Hirotsugu Sakamoto6Hironori Yamamoto7Department of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanDepartment of Medicine Division of Gastroenterology Jichi Medical University Tochigi JapanAbstract Objectives Endoscopic balloon dilation (EBD) is an effective treatment for intestinal strictures in Crohn's disease (CD). However, restenosis often occurs and requires repeat EBD or surgery. Previous studies have seldom examined restenosis with respect to stricture diameter, leaving the factors contributing to post‐EBD restenosis unclear. Our retrospective study indicated that complete mucosal healing significantly reduces restenosis after EBD in CD‐related small intestinal strictures. This prospective study aimed to validate these findings by accurately measuring stricture diameters in patients with CD. Methods We conducted a single‐center prospective study of patients with CD and small intestinal strictures. The patients underwent an EBD session between June 2022 and December 2023. Stricture diameters were measured using a calibrated small‐caliber‐tip transparent hood. Multivariate analysis was performed to identify factors influencing stricture progression. Results This study included 41 patients (33 men). The number of strictures detected between sessions increased from 159 to 170. The average diameter of all strictures and the narrowest stricture per patient showed slight increases. However, 73% of patients experienced stricture progression. The presence of ulcers between sessions was identified as a significant risk factor for stricture progression (odds ratio 7.59, p = 0.031). Patients achieving complete mucosal healing demonstrated a significant increase in the narrowest stricture diameter (+1.5 mm, p = 0.00089). Conclusions Complete mucosal healing is crucial for preventing stricture progression after EBD in patients with CD‐related small intestinal strictures.https://doi.org/10.1002/deo2.70121balloon dilationCrohn's diseaseendoscopyintestinal stricturesrestenosis |
| spellingShingle | Jun Owada Kunihiko Oguro Tomonori Yano Yusuke Ono Takuma Kobayashi Shoko Miyahara Hirotsugu Sakamoto Hironori Yamamoto Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease DEN Open balloon dilation Crohn's disease endoscopy intestinal strictures restenosis |
| title | Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease |
| title_full | Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease |
| title_fullStr | Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease |
| title_full_unstemmed | Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease |
| title_short | Complete mucosal healing prevents stricture progression after endoscopic balloon dilation in Crohn's disease |
| title_sort | complete mucosal healing prevents stricture progression after endoscopic balloon dilation in crohn s disease |
| topic | balloon dilation Crohn's disease endoscopy intestinal strictures restenosis |
| url | https://doi.org/10.1002/deo2.70121 |
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