학술논문
Medical, Endoscopic and Surgical Management of Stricturing Crohn's Disease: Current Clinical Practice.
Document Type
Academic Journal
Author
Fousekis FS; Department of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Mitselos IV; Department of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Tepelenis K; Department of Surgery, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Pappas-Gogos G; Department of Surgery, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Katsanos KH; Department of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Lianos GD; Department of Surgery, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Frattini F; Department of Surgery, ASST Settelaghi, 21100 Varese, Italy.; Vlachos K; Department of Surgery, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.; Christodoulou DK; Department of Gastroenterology and Hepatology, University Hospital of Ioannina, University of Ioannina, 45110 Ioannina, Greece.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
The development of fibrostenotic intestinal disease occurs in approximately one-third of patients with Crohn's disease and is associated with increased morbidity. Despite introducing new biologic agents, stricturing Crohn's disease remains a significant clinical challenge. Medical treatment is considered the first-line treatment for inflammatory strictures, and anti-TNF agents appear to provide the most considerable benefit among the available medical treatments. However, medical therapy is ineffective on strictures with a mainly fibrotic component, and a high proportion of patients under anti-TNF will require surgery. In fibrotic strictures or cases refractory to medical treatment, an endoscopic or surgical approach should be considered depending on the location, length, and severity of the stricture. Both endoscopic balloon dilatation and endoscopic stricturoplasty are minimally invasive and safe, associated with a small risk of complications. On the other hand, the surgical approach is indicated in patients not suitable for endoscopic therapy. This review aimed to present and analyze the currently available medical, endoscopic, and surgical management of stricturing Crohn's disease.