Systematic review: Endoscopic dilatation in Crohn's disease

Aliment Pharmacol Ther. 2007 Dec;26(11-12):1457-64. doi: 10.1111/j.1365-2036.2007.03532.x. Epub 2007 Sep 28.


Background: Endoscopic dilatation for Crohn's disease has been evaluated only in some small and heterogeneous studies.

Aim: To evaluate any association between the main clinical variables and endoscopic variables and the efficacy and safety of endoscopic dilatation in Crohn's disease.

Methods: A Medline search regarding pneumatic dilatation in Crohn's disease was performed. Several technical and clinical variables were extracted from each study to build up a descriptive, pool-data analysis. Data on individual patients were extracted from suitable studies to create a simulated population upon which a multivariate statistical analysis was performed.

Results: Thirteen studies enrolling 347 Crohn's disease patients were reviewed. Endoscopic dilatation was mainly applied to postsurgical strictures, being technically successful in 86% of the cases. Long-term clinical efficacy was achieved in 58% of the patients. Mean follow-up was as long as 33 months, corresponding to 800 patient years of follow-up. Major complication rate was 2%, being higher than 10% in two series. At multivariate analysis, a stricture length < or = 4 cm was associated with a surgery-free outcome (OR: 4.01; 95% CI: 1.16-13.8; P < 0.028).

Conclusions: Endoscopic dilatation is an effective and safe treatment for short strictures caused by Crohn's disease, impacting substantially on the natural history of these patients.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Catheterization / adverse effects
  • Catheterization / methods*
  • Constriction, Pathologic / therapy
  • Crohn Disease / therapy*
  • Endoscopy, Gastrointestinal / adverse effects
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged