P730 Effectiveness and safety of endoscopic balloon dilation of colorectal strictures in Crohn’s disease
M. TILMANT1, M. serrero2, F. Poullenot3, G. Bouguen4, B. Pariente5, R. Altwegg6, P. Basile7, J. Filippi8, P. Vanelslander9, A. Buisson10, L. Vuitton11, A. Desjeux2, D. Laharie3, E. Le Balch4, M. Nachury5, L. Boivineau6, G. Savoye7, X. Hebuterne8, L. Poincloux10, A. Lamrani12, M. Fumery1
1CHU Amiens Sud, Service d’hepato-gastroentérologie, Amiens, France, 2APHM Hopital Nord, Hepato-gastroenterologie, Marseille, France, 3Hopital Haut Leveque, Hépato-gastroentérologie, Bordeaux, France, 4CHU Pontchaillou, Gastroenterologie, Rennes, France, 5Hopital Claude huriez, Gastroentérologie, Lille, France, 6Hôpital Saint Eloi, Gastroentérologie, Montpellier, France, 7Hopital Charles Nicolle, Gastroentérologie, Rouen, France, 8Hopital de l’Archet, Gastroentérologie, Nice, France, 9Policlinique Saint Claude, Gastroentérologie, Saint Quentin, France, 10Hopital universitaire, Gastroentérologie, Clermont Ferrand, France, 11Hopital universitaire, Gastroentérologie, Besançon, France, 12CHU Amiens Sud, Statistique, Amiens, France
Background
Endoscopic balloon dilation (EBD) is widely used to manage Crohn’s disease (CD) ileal stricture. However, data of EBD on inflammatory bowel diseases (IBD) colorectal strictures are scarce.
Methods
We performed a retrospective study in 9 tertiary centres, including all consecutive IBD patients who underwent EBD for native or anastomotic colorectal stricture between 1999 and 2018. Outcomes were rate of technical success defined by a passable stricture at the end of the EBD, clinical success defined by a passable and asymptomatic stricture and colonic resection at the end of follow-up. Factors associated with EBD success were also investigated by logistic regression.
Results
Fifty-seven patients (25 women, median age: 36 years, InterQuartile Range, 31–48) were included. All patients had CD and 42 (74%) had symptomatic stricture. Regarding the 60 strictures, 52 (87%) were native and the most frequent location was left colon (27%). 39 (65%) measured less than 5 cm, 57 (95%) were non-passable by the scope and 35 (58%) ulcerated. Among the 161 EBD performed (median number of dilatations per strictures: 1, IQR 1–3), technical success was observed in 123 (76%) EBD. One perforation occurred (0.6% per EDB and 2% per patient). After a median follow-up of 4.3 years [IQR 2.0–8.4], 24 patients (42%) underwent colonic resection, 9 (16%) had symptomatic strictures non-passable by the scope, 11 (19%) had asymptomatic non-passable strictures and 13 (23%) had asymptomatic strictures passable by the scope. One colon lymphoma and one colorectal cancer were diagnosed (3.5% of patients), respectively on endoscopic biopsies and at the time of surgery. None factor was associated with technical, clinical success, or surgery including therapeutic modification.
Conclusion
EBD of CD-associated colorectal strictures is feasible, efficient and safe as more than 50% of patients avoid surgery.