To evaluate the safety and efficacy of endoscopic balloon dilation (EBD) and endoscopic stricturotomy with needle knife (NKSt) in patients with inflammatory bowel diseases (IBD)-relevant strictures. Methods: From July 2015 to September 2018, 14 patients undergoing double balloon-enteroscopy at the Third Xiangya Hospital of Central South University were enrolled. There was a total of 16 lesions. Endoscopic intervention was performed for 16 times. EBD was done for 11 times, and 5 stricturotomies were carried out. Regular follow-up and examinations were done to observe whether there was remission or recurrence of clinical symptoms and replacement surgery. Results: All 14 patients were successfully treated by endoscopy, and the success rate was 100%. Postoperative clinical symptoms were alleviated, and serious complications, such as perforation or hemorrhaging, did not occur. Obstructive symptoms were effectively alleviated at a median follow-up of 26.1 months (5.9-35.3 months) and 8.3 months (1.6-17.8 months) for patients with balloon dilatation and stricturotomy, respectively. Two patients presented with symptoms of obstruction. These were given conservative symptomatic treatment without surgical intervention. Conclusion: Enteroscopic treatments (EBD and NKSt) are safe and effective for intestinal strictures, and can prolong the time before surgical intervention is needed.
目的：探讨双腔气囊小肠镜的内镜下球囊扩张(endoscopic balloon dilation，EBD)和狭窄切开(endoscopic stricturotomy with needle knife，NKSt)对于小肠炎症性疾病相关狭窄治疗的安全性及有效性。方法：收集2015年7月至2018年9月在中南大学湘雅三医院行双腔气囊小肠镜狭窄治疗的患者14例，病变部位16处，内镜下干预16次(EBD 11次和NKSt 5次)。术后定期随访，观察患者的临床症状缓解和复发情况，以及是否能替代外科手术。结果：14例患者均成功行内镜治疗，操作成功率100%，未发生穿孔、大出血等严重并发症。EBD和NKSt患者分别在随访5.9~35.3(中位数26.1)个月及1.6~17.8(中位数8.3)个月内梗阻症状得到有效缓解，其中2例患者随访期间出现再次梗阻，予以保守对症处理后缓解，未行外科手术干预。结论：小肠镜下治疗(EBD和NKSt)对小肠炎症性疾病狭窄安全有效，可以推迟外科手术时间。.