Outcomes of endoscopic balloon dilatation for de novo and anastomotic Crohn’s strictures: a Canadian tertiary center experience
Abstract
Background: Over half of patients with Crohn’s disease (CD) develop intestinal strictures that often require surgical resection. Endoscopic balloon dilatation (EBD) can be a potential alternative therapeutic option.
Methods: This retrospective cohort study included adult patients with CD (≥18 years) who underwent EBD between January 2016 and September 2024 at two Canadian hospitals. The primary outcome was technical success. Secondary outcomes were clinical success at 6 and 12 months, hospitalization due to obstruction, and CD-related surgery. Cox proportional hazards models assessed predictors of outcomes.
Results: A total of 234 patients (age: 47.6 years, males: 47.4%) were included with mean disease duration of 17.7 years and median follow-up of 61 months. A majority of the strictures (226/234) were dilated under ileocolonoscopy guidance, and 79.4% had symptoms at baseline. Most strictures were of de novo type (62.5%) and the median number of stricture dilatations was 3 (IQR: 2). Technical success was achieved in 81% (150/185). Clinical success was noted in 47.7% at 6 months. The cumulative probabilities of being hospitalization-free were 96.9% (95% CI 94.7-99.2]) at 1 year, 91.3% (95% CI 87.5-95.2) at 3 years, and 85.0% (95% CI 79.8-90.5) at 5 years. The cumulative probabilities of being surgery-free were 91.1% (95% CI 87.5-94.9) at 1 year, 81.7% (95% CI 76.5-87.2) at 3 years, and 78.1% (95% CI 72.4-84.3) at 5 years. Multiple strictures were associated with an increased risk of surgery while anastomotic strictures and maximum balloon diameter were associated with lower risk. No patients experienced procedure-related complications.
Conclusions: EBD is effective and safe in de novo and anastomotic strictures with the majority of patients achieving technical success and being free of surgery within 5 years.
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BibTeX
@article{vuyyuru2026outcomes,
title = {{Outcomes of endoscopic balloon dilatation for de novo and anastomotic Crohn’s strictures: a Canadian tertiary center experience}},
author = {Sudheer Kumar Vuyyuru and Gaurav Nigam and Shane W Goodwin and Shivya Sethi and Jamie Gregor and Brian Yan and Michael Sey and Vipul Jairath},
journal = {Journal of Crohn's \& Colitis},
year = {2026},
month = nov,
doi = {10.1093/ecco-jcc/jjag172},
url = {https://doi.org/10.1093/ecco-jcc/jjag172},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Outcomes of endoscopic balloon dilatation for de novo and anastomotic Crohn’s strictures: a Canadian tertiary center experience
AU - Sudheer Kumar Vuyyuru
AU - Gaurav Nigam
AU - Shane W Goodwin
AU - Shivya Sethi
AU - Jamie Gregor
AU - Brian Yan
AU - Michael Sey
AU - Vipul Jairath
PY - 2026
DA - 2026/11/04
JO - Journal of Crohn's & Colitis
DO - 10.1093/ecco-jcc/jjag172
UR - https://doi.org/10.1093/ecco-jcc/jjag172
AB - Background: Over half of patients with Crohn’s disease (CD) develop intestinal strictures that often require surgical resection. Endoscopic balloon dilatation (EBD) can be a potential alternative therapeutic option. Methods: This retrospective cohort study included adult patients with CD (≥18 years) who underwent EBD between January 2016 and September 2024 at two Canadian hospitals. The primary outcome was technical success. Secondary outcomes were clinical success at 6 and 12 months, hospitalization due to obstruction, and CD-related surgery. Cox proportional hazards models assessed predictors of outcomes. Results: A total of 234 patients (age: 47.6 years, males: 47.4%) were included with mean disease duration of 17.7 years and median follow-up of 61 months. A majority of the strictures (226/234) were dilated under ileocolonoscopy guidance, and 79.4% had symptoms at baseline. Most strictures were of de novo type (62.5%) and the median number of stricture dilatations was 3 (IQR: 2). Technical success was achieved in 81% (150/185). Clinical success was noted in 47.7% at 6 months. The cumulative probabilities of being hospitalization-free were 96.9% (95% CI 94.7-99.2]) at 1 year, 91.3% (95% CI 87.5-95.2) at 3 years, and 85.0% (95% CI 79.8-90.5) at 5 years. The cumulative probabilities of being surgery-free were 91.1% (95% CI 87.5-94.9) at 1 year, 81.7% (95% CI 76.5-87.2) at 3 years, and 78.1% (95% CI 72.4-84.3) at 5 years. Multiple strictures were associated with an increased risk of surgery while anastomotic strictures and maximum balloon diameter were associated with lower risk. No patients experienced procedure-related complications. Conclusions: EBD is effective and safe in de novo and anastomotic strictures with the majority of patients achieving technical success and being free of surgery within 5 years.
SN - 1873-9946
SN - 1876-4479
ER -