Original articleAlimentary tractComparison of Endoscopic Dilation vs Surgery for Anastomotic Stricture in Patients With Crohn's Disease Following Ileocolonic Resection
Section snippets
Patients
Data of EBD became available since 1998 at our institution. A historical cohort of eligible patients with ICA stricture treated with either EBD or surgery between December 1998 and February 2014 were evaluated. Patients who underwent EBD for CD at the Center for Inflammatory Bowel Diseases were identified from an electronic medical record system; those undergoing surgery for CD-related ICA stricture were identified from a prospectively maintained CD database at Department of Colorectal Surgery
Results
A total of 307 eligible patients were included. EBD was performed in 176 and surgery in 131 patients.
Discussion
Our study is the first investigation in the literature to directly compare EBD and surgery for ICA stricture in patients with CD. We demonstrate that the average time to surgery delayed by dilation was 6.45 years in the endoscopy group, suggesting the benefit of EBD in this setting. However, multivariable Cox regression analysis showed that patients undergoing the upfront surgery for ICA stricture had a lower risk for subsequent surgery for CD. This is consistent with the findings of a recent
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This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e138. Learning Objective–Upon completion of this activity, successful learners will be able to understand the disease process of anastomotic stricture in Crohn’s disease and select proper treatment, medical vs endoscopic vs surgical.
Conflicts of interest The authors disclose no conflicts.
Funding This study was partially supported by the Ed and Joey Story Endowed Chair (to B.S.).