AI Article Synopsis
- A study investigated the outcomes and treatment options for patients with Crohn's disease (CD) who have a narrowing (stricture) of the upper gastrointestinal tract (UGT).
- The study included 60 CD patients, finding that 60% of strictures were in the duodenum, with 75% of patients remaining surgery-free after 1 year and 64% after 5 years.
- Treatment options including anti-TNF medications and endoscopic procedures were effective, with over 80% immediate success rates in endoscopic interventions, allowing many patients to avoid surgery.
Article Abstract
Background: There are few data concerning patients with Crohn's disease (CD) complicated by a stricture of the upper gastrointestinal tract (UGT).
Aims: We evaluated the outcome and management of CD patients complicated by a stricture of the UGT.
Methods: We performed a retrospective multicenter study including all CD patients with a non-passable symptomatic UGT stricture on endoscopy. Primary outcome measure was surgery-free survival from diagnosis of stricture. Efficacy of medical, endoscopic, and surgical treatments, and identification of predictors of surgery were also evaluated.
Results: 60 CD patients with an UGT stricture were included. 60% of the strictures were located in the duodenum. With a median follow-up of 5.5 (IQR: 3.0-12.0) years since stricture diagnosis, surgical-free survival was 75% and 64% at 1 and 5 years, respectively. At the end of the follow up, 27 (45%) patients underwent surgery. 77 endoscopic procedures were performed in 30 patients with an immediate success of 81% and a clinical benefit in 84% of the procedures. In multivariate analysis, anti-TNF treatment initiation was associated with a reduced risk of surgery.
Conclusion: CD UGT strictures are mainly located in the duodenum. Medical and endoscopic treatments allow to avoid surgery in half of the patients.
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| http://dx.doi.org/10.1016/j.dld.2020.08.034 | DOI Listing |
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