Abstract | BACKGROUND: METHODS: Consecutive IBD patients with pouches from the Pouchitis Clinic who underwent nonfluoroscopy-guided outpatient endoscopic therapy were studied. The location, number, degree (range 0-3), and length of strictures and balloon size were documented. Efficacy and safety were evaluated with univariate and multivariate analyses. RESULTS: A total of 150 patients with pouch strictures were studied. Stricture locations were at the pouch inlet (n = 96), outlet (n = 73), afferent limb (n = 33), and pouch body (n = 2). A cumulative of 646 strictures were endoscopically dilated, with a total of 406 pouchoscopies. The median stricture score was 1 (interquartile range [IQR] 1-2); the median stricture length was 1 (IQR 0.5-1.25) cm, and the median balloon size was 20 (IQR 18-20) mm. Of 406 therapeutic endoscopies performed, there were two perforations (0.46%) and four transfusion-required bleeding (0.98%). The 5-, 10-, and 25-year pouch retention rates were 97%, 90.6%, and 85.9%, respectively. In a median follow-up of 9.6 (IQR 6-17) years, 131 patients (87.3%) were able to retain their pouches. The number of strictures and underlying diagnosis were independent risk factors for pouch failure in the Cox regression model. CONCLUSIONS: Endoscopic treatment of pouch stricture appears to be efficacious and generally safe to perform in experienced hands. Underlying diagnosis of Crohn's disease of the pouch and surgery-related strictures and multiple strictures were the risk factors for pouch failure.
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Authors | Bo Shen, Lei Lian, Ravi P Kiran, Elaine Queener, Ian C Lavery, Victor W Fazio, Feza H Remzi |
Journal | Inflammatory bowel diseases
(Inflamm Bowel Dis)
Vol. 17
Issue 12
Pg. 2527-35
(Dec 2011)
ISSN: 1536-4844 [Electronic] England |
PMID | 21351202
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2011 Crohn's & Colitis Foundation of America, Inc. |
Topics |
- Adult
- Catheterization
- Colonic Pouches
(adverse effects)
- Constriction, Pathologic
(etiology, therapy)
- Crohn Disease
(complications, therapy)
- Endoscopy, Gastrointestinal
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Pouchitis
(etiology, therapy)
- Safety
- Survival Rate
- Treatment Outcome
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