Risk factors for difficult endoscopic bowel dilation of predominantly shorter and noninflammatory strictures among patients with inflammatory bowel disease: findings from inflammatory bowel disease tertiary centers in Poland and Czech Republic

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F25%3A43928199" target="_blank" >RIV/00064173:_____/25:43928199 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11120/25:43928199

Výsledek na webu

<a href="https://doi.org/10.1016/j.gie.2025.02.036" target="_blank" >https://doi.org/10.1016/j.gie.2025.02.036</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.gie.2025.02.036" target="_blank" >10.1016/j.gie.2025.02.036</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Risk factors for difficult endoscopic bowel dilation of predominantly shorter and noninflammatory strictures among patients with inflammatory bowel disease: findings from inflammatory bowel disease tertiary centers in Poland and Czech Republic

Popis výsledku v původním jazyce

BACKGROUND AND AIMS: Intestinal strictures are a common and serious complication of inflammatory bowel disease (IBD). Endoscopic balloon dilatation (EBD) is the first step treatment to avoid the surgery. The aim of this study was to assess the prevalence, risk factors and clinical sequelae of difficult EBD. In this retrospective, multi-center study, 861 IBD patients treated with EBD due to strictures were included. We evaluated the risk factors for difficult EBD, defined as a &gt;=3 per year. RESULTS: During 23.00 (14.00;42.00) months of median follow-up there were 392 (45.5%) easier EBD performed, while difficult EBD were done in 489 (54.5%) cases. Long term efficacy of EBD, defined as a &gt;12 months without surgery was achieved in 392 (100%) easier vs in 457 (97.4%) difficult EBD, V = 0.11, P = 0.004. However, 149 (17.3%) patients underwent surgery due to unsuccessful EBD. The most important risk factors for difficult EBD, classified as modifiable, were smoking and treatment with adalimumab (especially if through level was normal) and ustekinumab. While vedolizumab (VDZ) and immunosuppressive therapy was identified as a protective factor. The multivariable logistic regression indicated good fit of the model to the data, pointing to protective role of total parental nutrition (TPN) and worsening of smoking (for both P &lt; 0.001). CONCLUSIONS: Reduction of difficult EBD should be considered primarily in the context of their modifiable risk factors. Prospective studies with simultaneous evaluation of transmural healing are needed to truly assess whether VDZ treatment, immunosuppressive therapy and total parenteral nutrition reduce the risk of EBD.

Název v anglickém jazyce

Risk factors for difficult endoscopic bowel dilation of predominantly shorter and noninflammatory strictures among patients with inflammatory bowel disease: findings from inflammatory bowel disease tertiary centers in Poland and Czech Republic

Popis výsledku anglicky

BACKGROUND AND AIMS: Intestinal strictures are a common and serious complication of inflammatory bowel disease (IBD). Endoscopic balloon dilatation (EBD) is the first step treatment to avoid the surgery. The aim of this study was to assess the prevalence, risk factors and clinical sequelae of difficult EBD. In this retrospective, multi-center study, 861 IBD patients treated with EBD due to strictures were included. We evaluated the risk factors for difficult EBD, defined as a &gt;=3 per year. RESULTS: During 23.00 (14.00;42.00) months of median follow-up there were 392 (45.5%) easier EBD performed, while difficult EBD were done in 489 (54.5%) cases. Long term efficacy of EBD, defined as a &gt;12 months without surgery was achieved in 392 (100%) easier vs in 457 (97.4%) difficult EBD, V = 0.11, P = 0.004. However, 149 (17.3%) patients underwent surgery due to unsuccessful EBD. The most important risk factors for difficult EBD, classified as modifiable, were smoking and treatment with adalimumab (especially if through level was normal) and ustekinumab. While vedolizumab (VDZ) and immunosuppressive therapy was identified as a protective factor. The multivariable logistic regression indicated good fit of the model to the data, pointing to protective role of total parental nutrition (TPN) and worsening of smoking (for both P &lt; 0.001). CONCLUSIONS: Reduction of difficult EBD should be considered primarily in the context of their modifiable risk factors. Prospective studies with simultaneous evaluation of transmural healing are needed to truly assess whether VDZ treatment, immunosuppressive therapy and total parenteral nutrition reduce the risk of EBD.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30219 - Gastroenterology and hepatology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Gastrointestinal Endoscopy

ISSN

0016-5107

e-ISSN

1097-6779

Svazek periodika

102

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

571-580

Kód UT WoS článku

001580813300028

EID výsledku v databázi Scopus

2-s2.0-105002663481