Endoprosthetic management of refractory ileocolonic anastomotic strictures after resection for Crohn's disease: Report of nine-year follow-up and review of the literature

Rebecca Levine, Harry Wasvary, Omar Kadro

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: The role of endoluminal stenting in benign obstruction, especially for Crohn's disease (CD), is controversial, with limited data and widely disparate outcomes. The purpose of this study was to determine the long-term efficacy and safety of this technology in the treatment of fibrostenotic CD and to review the existing literature on this topic. Methods: We undertook a retrospective review of all patients undergoing endoluminal stenting for CD strictures at our institution from 2001 to 2010. Outcome measures included technical success, clinical improvement, duration of stent and luminal patency, and need for re-intervention. Results: Five patients underwent this procedure with a 100% rate of technical and an 80% rate of clinical success. Mean follow-up was 28 months (range 3 weeks to 109 months) and mean long-term luminal patency was 34.8 months (range 4.5-109 months). There was one complication involving reobstruction which required surgical intervention and no mortalities. Conclusions: Endoluminal stenting of CD strictures is a safe and effective alternative to surgery which can provide lasting benefit in select patients. Further studies are necessary to clarify the full impact of this technology on long-term management of this complex disease.

Original languageEnglish (US)
Pages (from-to)506-512
Number of pages7
JournalInflammatory Bowel Diseases
Volume18
Issue number3
DOIs
StatePublished - Mar 2012

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Crohn Disease
Pathologic Constriction
Technology
Disease Management
Stents
Outcome Assessment (Health Care)
Safety
Mortality
Therapeutics

Keywords

  • Crohn's disease
  • endoscopy
  • obstruction
  • stents
  • stricture

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

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abstract = "Background: The role of endoluminal stenting in benign obstruction, especially for Crohn's disease (CD), is controversial, with limited data and widely disparate outcomes. The purpose of this study was to determine the long-term efficacy and safety of this technology in the treatment of fibrostenotic CD and to review the existing literature on this topic. Methods: We undertook a retrospective review of all patients undergoing endoluminal stenting for CD strictures at our institution from 2001 to 2010. Outcome measures included technical success, clinical improvement, duration of stent and luminal patency, and need for re-intervention. Results: Five patients underwent this procedure with a 100{\%} rate of technical and an 80{\%} rate of clinical success. Mean follow-up was 28 months (range 3 weeks to 109 months) and mean long-term luminal patency was 34.8 months (range 4.5-109 months). There was one complication involving reobstruction which required surgical intervention and no mortalities. Conclusions: Endoluminal stenting of CD strictures is a safe and effective alternative to surgery which can provide lasting benefit in select patients. Further studies are necessary to clarify the full impact of this technology on long-term management of this complex disease.",
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