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Practical guidelines on endoscopic treatment for Crohn's disease strictures: a consensus statement from the Global Interventional Inflammatory Bowel Disease Group.

Center for Interventional Inflammatory Bowel Disease, Columbia University Irving Medical Center, New York Presbyterian Hospital, NY, USA. Electronic address: bs3270@cumc.columbia.edu. Division of Gastroenterology, Hepatology and Nutrition, Allegheny Health Network, Pittsburgh, PA, USA. Center for Interventional Endoscopy, Florida Hospital, Orlando, FL, USA. Department of Gastroenterology, Mayo Clinic Jacksonville, Jacksonville, FL, USA. Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, TN, USA. Institute of Translational Medicine, Institute of Immunology and Immunotherapy, NIHR Birmingham Biomedical Research Centre, University Hospitals NHS Foundation Trust, University of Birmingham, Birmingham, UK. Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada. Department of Gastroenterology, University Louisville Medical Center, Louisville, KY, USA. Inflammatory Bowel Disease Program, University of Maryland School of Medicine, Maryland, MD, USA. Department of Gastroenterology, Mayo Clinic, Rochester, MN, USA. Center for Advanced Inflammatory Bowel Disease Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan. Clinical and Research Centre for Inflammatory Bowel Disease, ISCARE Clinical Centre, Prague, Czech Republic. San Francisco Veterans Affairs Medical Center and Department of Gastroenterology, University of California, San Francisco, CA, USA. Department of Colorectal Surgery, The 6th Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Division of Gastroenterology, University of Mississippi Medical Center, Jackson, MS, USA. IBD Outpatients Clinic, Catholic University of Paraná, Curitiba, Brazil. Division of Colorectal Surgery, Columbia University Presbyterian Medical Center, New York, NY, USA. Department of Gastroenterology, University of California San Diego Medical Center, San Diego, CA, USA. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Department of Gastroenterology, Peking University People's Hospital, Beijing, China. Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China. Servei de Gastroenterologia, Instituto Clínic de Enfermedades Digestivas y Metabólicas, Hospital Clínic de Barcelona, Barcelona, Spain. IBD Unit, Gastroenterology and Hepatology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain. Mount Sinai Hospital Inflammatory Bowel Disease Centre, Toronto, ON, Canada.

The lancet. Gastroenterology & hepatology. 2020;(4):393-405
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Abstract

Stricture formation is a common complication of Crohn's disease, resulting from the disease process, surgery, or drugs. Endoscopic balloon dilation has an important role in the management of strictures, with emerging techniques, such as endoscopic electroincision and stenting, showing promising results. The underlying disease process, altered bowel anatomy from disease or surgery, and concurrent use of immunosuppressive drugs can make endoscopic procedures more challenging. There is an urgent need for the standardisation of endoscopic procedures and peri-procedural management strategies. On the basis of an extensive literature review and the clinical experience of the consensus group, which consisted of representatives from the Interventional Inflammatory Bowel Disease Group, we propose detailed guidance on all aspects of the principles and techniques for endoscopic procedures in the treatment of inflammatory bowel disease-associated strictures.

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Publication Type : Review

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