A111 LONG-TERM SAFETY AND OUTCOMES OF COLONOSCOPIC BALLOON DILATION FOR STRICTURING CROHN’S DISEASE

Stricture formation occurs in 18% of Crohn’s disease (CD) patients with long-term disease. Traditionally, surgical therapy has been required to treat the strictures. However, colonoscopic balloon dilation (CBD) has become the standard less invasive approach. Assessing the long-term safety and outcomes of CBD in our cohort of CD patients with strictures. We conducted a retrospective chart review of CD patients with strictures in our tertiary centre who underwent CBD from January 2006 to June 2017 and were followed for at least 6 months. The primary outcome was post-CBD complication rate. Secondary outcomes included post-CBD hospitalization, surgery and mortality. A total of 127 patients with 193 strictures were included in the analysis. CBDs were performed in symptomatic patients with obstructive symptoms. The mean age of the patients was 46.8 years (range 20–86). 63.8% of patients were females. Anastomotic strictures were the cause in 55.9% of patients. High-pressure endoscopic balloons with a diameter of 8–20 mm and length of 5.5 cm were used to perform CBD depending on stricture’s lumen size and endoscopist’s decision. The median maximum dilation diameter was 15 mm. Successful colonoscopic dilations were achieved in 96.4% of which 76.2% had the endoscope passing through the stricture after CBD. Patients had symptomatic relief in 88.6% of the procedures. 8.8% of the strictures underwent second dilations. 4.7% of the strictures were dilated three times while 2.1% underwent four dilations or more in total. Mean (± SD) follow-up time was 42.6 ± 35.2 months. Complications occurred in 2.6% (5/193) of the CBDs. 1.6% (3/193) of the CBDs required post-procedural hospitalization. One perforation (0.5%) occurred after the third dilation of a stricture. Two patients experienced post-CBD bleeding requiring hospitalization and blood transfusion while another two patients experienced self-limited pain. 30.6% (59/193) of the strictures required surgical treatment eventually. One patient (0.5%) died from post-surgical sepsis after an unsuccessful third CBD. Dilated anastomotic strictures were more likely to undergo repeat dilations (21.8% vs. 18.1%; p=0.7), surgical treatment (17.1% vs. 13.5%; p=0.57) and to have post-CBD complications (2.1% vs. 0.5%; p=0.22) when compared to primary strictures. CBD is a non-invasive and safe treatment option for CD strictures with excellent procedural dilation success and post-procedural symptomatic improvement. None

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