PDF(Pubmed)
Abstract：
UNASSIGNED: Crohn\'s disease (CD) of the small bowel is associated with a severe course and increased risk of complications. Strictures at this location are challenging to diagnose and out-of-reach of colonoscopy. We aimed to evaluate the detection rate of small bowel strictures with magnetic resonance enterography (MRE) and assess the efficacy of double balloon enteroscopy-assisted endoscopic balloon dilatation (DBE-assisted EBD) in managing these strictures.
UNASSIGNED: A retrospective study included all patients with DBE-assisted EBD of small bowel strictures in CD in our facility. All patients had MRE to detect strictures prior to the dilatation. Sequential dilatation protocol was performed using through-the-scope (TTS) working channel balloons. The outcomes included technical success defined by the passage of the enteroscope post-dilatation, resolution of symptoms, and the requirement of repeated procedures or surgery during 12 months of follow-up.
UNASSIGNED: Twenty DBE-assisted EBDs of small bowel strictures were attempted during 13 DBE procedures in 10 patients (6 males, median age 42). MRE identified 75% of the strictures with 100% accuracy in localisation. Retrograde DBE was the approach in 16/20 (80%) strictures. Anaesthetic intubation was used in 8/20 (40%). DBE reached 19/20 strictures. All the reached strictures were dilated successfully; the technical success following dilatation was 72.2%. The median DBE insertion time with TTS balloon dilatation was 66 min. Three patients required follow-up dilatations within 2-3 months. Surgery was not needed during the follow-up period.
UNASSIGNED: MRE is essential in diagnosing and localising small bowel strictures in CD. DBE reached 95% of strictures with successful dilatation. Immediate technical success was high, and safety was demonstrated. Planned repeat procedures for sequential dilatation were performed in a few patients. Surgical resection was avoided in all patients.
UNASSIGNED: A retrospective study included all patients with DBE-assisted EBD of small bowel strictures in CD in our facility. All patients had MRE to detect strictures prior to the dilatation. Sequential dilatation protocol was performed using through-the-scope (TTS) working channel balloons. The outcomes included technical success defined by the passage of the enteroscope post-dilatation, resolution of symptoms, and the requirement of repeated procedures or surgery during 12 months of follow-up.
UNASSIGNED: Twenty DBE-assisted EBDs of small bowel strictures were attempted during 13 DBE procedures in 10 patients (6 males, median age 42). MRE identified 75% of the strictures with 100% accuracy in localisation. Retrograde DBE was the approach in 16/20 (80%) strictures. Anaesthetic intubation was used in 8/20 (40%). DBE reached 19/20 strictures. All the reached strictures were dilated successfully; the technical success following dilatation was 72.2%. The median DBE insertion time with TTS balloon dilatation was 66 min. Three patients required follow-up dilatations within 2-3 months. Surgery was not needed during the follow-up period.
UNASSIGNED: MRE is essential in diagnosing and localising small bowel strictures in CD. DBE reached 95% of strictures with successful dilatation. Immediate technical success was high, and safety was demonstrated. Planned repeat procedures for sequential dilatation were performed in a few patients. Surgical resection was avoided in all patients.
摘要：
■小肠克罗恩病（CD）与严重病程和并发症风险增加有关。该位置的狭窄对结肠镜检查的诊断和无法到达具有挑战性。我们旨在评估磁共振小肠造影（MRE）对小肠狭窄的检出率，并评估双气囊小肠镜辅助内镜球囊扩张术（DBE辅助EBD）在治疗这些狭窄中的疗效。
■一项回顾性研究纳入了我们机构中所有患有DBE辅助的CD小肠狭窄EBD患者。所有患者在扩张前都有MRE来检测狭窄。使用通过范围（TTS）工作通道气球执行顺序扩张协议。结果包括由肠镜扩张后通过定义的技术成功，症状的解决，以及12个月随访期间重复手术或手术的要求。
■在10例患者（6例男性，中位年龄42）。MRE识别出75%的狭窄，定位准确率为100%。逆行DBE是16/20（80％）狭窄的方法。8/20(40%)采用麻醉插管。DBE达到19/20的狭窄。所有达到的狭窄均已成功扩张；扩张后的技术成功率为72.2％。TTS球囊扩张的中位DBE插入时间为66分钟。3例患者需要在2-3个月内进行随访扩张。随访期间不需要手术。
■MRE对CD中小肠狭窄的诊断和定位至关重要。通过成功的扩张，DBE达到了狭窄的95％。立即技术成功很高，并证明了安全性。在少数患者中进行了计划的重复程序以进行顺序扩张。所有患者均避免手术切除。
■一项回顾性研究纳入了我们机构中所有患有DBE辅助的CD小肠狭窄EBD患者。所有患者在扩张前都有MRE来检测狭窄。使用通过范围（TTS）工作通道气球执行顺序扩张协议。结果包括由肠镜扩张后通过定义的技术成功，症状的解决，以及12个月随访期间重复手术或手术的要求。
■在10例患者（6例男性，中位年龄42）。MRE识别出75%的狭窄，定位准确率为100%。逆行DBE是16/20（80％）狭窄的方法。8/20(40%)采用麻醉插管。DBE达到19/20的狭窄。所有达到的狭窄均已成功扩张；扩张后的技术成功率为72.2％。TTS球囊扩张的中位DBE插入时间为66分钟。3例患者需要在2-3个月内进行随访扩张。随访期间不需要手术。
■MRE对CD中小肠狭窄的诊断和定位至关重要。通过成功的扩张，DBE达到了狭窄的95％。立即技术成功很高，并证明了安全性。在少数患者中进行了计划的重复程序以进行顺序扩张。所有患者均避免手术切除。
