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Endoscopic treatmen...
Endoscopic treatment of Crohn-related strictures with a self-expandable stent compared with balloon dilation: a prospective, randomised, controlled study
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- Hedenström, Per (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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- Stotzer, Per-Ove, 1958 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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(creator_code:org_t)
- 2021-03-15
- 2021
- Engelska.
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Ingår i: Bmj Open Gastroenterology. - : BMJ. - 2054-4774. ; 8:1
- Relaterad länk:
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https://bmjopengastr...
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visa fler...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective Fibrotic strictures in the gastrointestinal tract are frequent in Crohn's disease. Endoscopic dilation is a standard treatment. However, recurrence is common after dilation and there are complications such as bleeding or perforation. Endoscopic treatment using self-expandable metal stents has shown diverging results. The aim of this study was to evaluate the outcome of endoscopic treatment with a self-expandable stent in ileocecal Crohn's disease. Design/method Patients with Crohn's disease and a symptomatic ileocecal stricture were eligible for prospective, consecutive inclusion in a single-centre setting. Patients were randomised to treatment with either 18 mm balloon dilatation (Group(DIL)) or stenting (Group(STENT)) using a 20 mm diameter, partially covered Hanarostent NCN. Patients were followed for a minimum of 24 months postendoscopy. Outcomes were technical success, adverse events and clinical success (defined as no need for repeated interventions). Results Thirteen patients (Group(DIL) n=6; Group(STENT)=7) were included with twelve patients (Group(DIL) n=5; Group(STENT)=7) being eligible for complete follow-up. Technical success was achieved in all cases. Adverse events were border-line significantly more common in the Group(STENT): 4/7 (57%) (pain: n=3; pain and rectal bleeding: n=1) compared with the Group(DIL): 0/5 (0%), p=0.08, which resulted in preterm termination of the study. The clinical success rate was Group(STENT): 6/7 (86%) vs Group(DIL): 1/5 (20%), p=0.07. Conclusion Patients with strictures related to Crohn's disease may benefit from treatment with self-expandable metal stents rather than dilatation. However, there seems to be an increased risk for patient pain after stenting, which has to be considered and handled.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Nyckelord
- fibrosis
- endoscopy
- stents
- s disease
- Gastroenterology & Hepatology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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