Table 2.
Summary of Study Details from Literature Review of Endoscopic Intralesional Therapy of Small Bowel Crohn’s Disease Strictures
| First Author, Year of Publication | Country | Study Design | Number of Patients | Stricture Definition (endoscopy/radiology/clinical) | CD/UC | IPAA Associated Stricture (Yes/No) | Stricture Length (cm) | Intervention (Medicaiton/Dilation/Surgery, %) | Median Follow Up Period | Complications | Outcomes (Surgery/Repeat EBD) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Atreja, 2014 | USA | R | 128; 44 intralesional steroid | CTE, MRE, endoscopy | 1369 | Upper GI (2.4%), Jejunum (0%), Ileum (77.5%) | 2.7 ± 1.9 | Balloon | 1.8 years | 36% (16/44) | No difference with EBD only patients |
| Brooker, 2003 | UK | R | 14 | Endoscopy | N/A | Ileocolonic (9), ileorectal (1), Ileum (1), left colon (2), one patient had ileocolonic and 3 colonic strictures. | Maximum 7cm | Balloon | 16.4 months (single EBD), 28 months (multiple EBD) | 25.0% (3/12) | 25.0% (3/12) |
| East, 2007 | UK | RCT | 13 (7 steroid, 6 saline placebo) | Barium small bowel follow through | N/A | Ileocolonic anastomosis | 2.0 | Balloon ± guide-wire | 52 weeks | N/A, study prematurely terminated. | 71.4% (5/7; steroid), 16.7% (1/6;placebo) |
| Foster, 2008 | USA | R | 24 (22 adults and 2 pediatric patients) 17 received steroid) | Endoscopy | N/A | 12 anastomotic, 16 de novo (4 colon, 5 rectum, 1 ileocecal valve, 6 small bowel) | < 4 | Balloon | 29 months | 11.8% (2/17) | 54% (13/24) |
| Hendel, 2014 | Belgium | P | 6 | MRI, endoscopy | 1/patient | Jejunum, 16.7% (1/6), Ileum 16.7% (1/6), duodenal bulb 16.7% (1/6), Ileocolic anastomosis 50% (3/6) | < 5 | Balloon | 6 months | 0 | 83.3% (5/6) received ≥ 2 EBD during 6 months. |
| Lian, 2015 | USA | R | 185; 35 intralesional steroid | CT, CTE, MRE, barium | 1/patient | ileocolic | N/A | Balloon | 3.9 years (mean) | 37.1% (13/35) | N/A |
| Ramboer, 1995 | Belgium | P | 13 | Endoscopy | 1/patient | ileocolic anastomosis (9/13) neoterminal ileum (2/13) | N/A | Balloon | 47 months (mean) | 0 | 84.6% (11/13) required repeat EBD. |
| Singh, 2005 | USA | R | 17; 7 fibrostenotic small bowel; 5 patients intralesional steroid | Endoscopy | 20 | Ileal (1/7), 3 (ileocolonic), 3 (duodenal bulb) | 2 | Balloon | 19 months (mean) | 20% (1/5) | 20% (1/5) |
EBD – endoscopic balloon dilation, IFX – infliximab