Endoscopic therapy of stoma closure site strictures in ileal pouches is safe and effective  

作　　者：Osama Jabi Nan Lan Akshay Pokala Ravi P.Kiran Bo Shen 

机构地区：[1]The Global Center for Integrated Colorectal Surgery and IBD Interventional Endoscopy,Columbia University Irving Medical Center/New York-Presbyterian Hospital,New York,NY,USA

出　　处：《Gastroenterology Report》2024年第1期236-242,共7页胃肠病学报道(英文)

摘　　要：Background:Strictures are a common complication after ileal pouch surgery with the most common locations being at the anasto-mosis,pouch inlet,and stoma closure site.No previous literature has described endoscopic therapy of stoma site stricture.This study aimed to assess the safety and efficacy of endoscopic therapy in the treatment of stoma closure site strictures.Method:Patients diagnosed with stoma closure site strictures following ileal pouch surgery who underwent endoscopic treatment at the Center for Colorectal Diseases,Inflammatory Bowel Disease(IBD),and Ileal Pouch between 2018 and 2022 were analysed.Primary outcomes(technical success and surgery-free survival)were compared between endoscopic balloon dilation(EBD)and stricturotomy and/or strictureplasty.Results:A total of 30 consecutive eligible patients were analysed.Most patients were female(66.7%)and most patients were diag-nosed with IBD(93.3%).Twenty patients(66.7%)had end-to-end anastomosis.A total of 52 procedures were performed,with EBD in 16(30.8%)and stricturotomy and/or strictureplasty in 36(69.2%).The mean stricture length was 1.7±1.0 cm.Immediate technical success was achieved in 47 of 52 interventions(90.4%).During a mean follow-up of 12.7±9.9 months,none of the patients underwent surgical intervention for the stricture.Fourteen(46.7%)required endoscopic re-intervention for their strictures with an interval be-tween index and re-interventional pouchoscopy of 8.8±6.3 months.Post-procedural complications were reported in 2(6.7%)with bleeding and none with perforation.Upon follow-up,20(66.7%)patients reported improvement in their symptoms.Conclusion:EBD and endoscopic stricturotomy and/or strictureplasty are safe and effective in treating stoma closure site strictures in patients with ileal pouches,providing symptomatic relief in most patients as well as avoiding surgery.

关 键 词：endoscopy DILATION POUCH STRICTURE stoma closure stricturotomy 

分 类 号：R57[医药卫生—消化系统]