Long-term outcome of Crohn's disease patients with upper gastrointestinal stricture: A GETAID study.
BACKGROUND: There are few data concerning patients with Crohn's disease (CD) complicated by a stricture of the upper gastrointestinal tract (UGT). AIMS: We evaluated the outcome and management of CD patients complicated by a stricture of the UGT. METHODS: We performed a retrospective multicenter study including all CD patients with a non-passable symptomatic UGT stricture on endoscopy. Primary outcome measure was surgery-free survival from diagnosis of stricture. Efficacy of medical, endoscopic, and surgical treatments, and identification of predictors of surgery were also evaluated. RESULTS:... Mehr ...
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Dokumenttyp: | journal article |
Erscheinungsdatum: | 2020 |
Schlagwörter: | Tumor Necrosis Factor Inhibitors / Adolescent / Adult / Belgium / Constriction / Pathologic/etiology/therapy / Crohn Disease/complications/therapy / Endoscopy / Gastrointestinal/standards / Female / France / Humans / Logistic Models / Male / Middle Aged / Multivariate Analysis / Retrospective Studies / Treatment Outcome / Tumor Necrosis Factor Inhibitors/therapeutic use / Upper Gastrointestinal Tract/pathology / Young Adult / Crohn's disease / Endoscopic treatment / Stricture / Surgery / Upper gastrointestinal tract / Human health sciences / Gastroenterology & hepatology / Sciences de la santé humaine / Gastroentérologie & hépatologie |
Sprache: | Englisch |
Permalink: | https://search.fid-benelux.de/Record/base-28941395 |
Datenquelle: | BASE; Originalkatalog |
Powered By: | BASE |
Link(s) : | https://orbi.uliege.be/handle/2268/311918 |
BACKGROUND: There are few data concerning patients with Crohn's disease (CD) complicated by a stricture of the upper gastrointestinal tract (UGT). AIMS: We evaluated the outcome and management of CD patients complicated by a stricture of the UGT. METHODS: We performed a retrospective multicenter study including all CD patients with a non-passable symptomatic UGT stricture on endoscopy. Primary outcome measure was surgery-free survival from diagnosis of stricture. Efficacy of medical, endoscopic, and surgical treatments, and identification of predictors of surgery were also evaluated. RESULTS: 60 CD patients with an UGT stricture were included. 60% of the strictures were located in the duodenum. With a median follow-up of 5.5 (IQR: 3.0-12.0) years since stricture diagnosis, surgical-free survival was 75% and 64% at 1 and 5 years, respectively. At the end of the follow up, 27 (45%) patients underwent surgery. 77 endoscopic procedures were performed in 30 patients with an immediate success of 81% and a clinical benefit in 84% of the procedures. In multivariate analysis, anti-TNF treatment initiation was associated with a reduced risk of surgery. CONCLUSION: CD UGT strictures are mainly located in the duodenum. Medical and endoscopic treatments allow to avoid surgery in half of the patients.