A144 THE EFFICACY OF COLONOSCOPIC BALLOON DILATION IN STRICTURING CROHN’S DISEASE
Bibliographic record
Abstract
Stricture formation is one of the most common complications of Crohn’s disease. Management options include medical therapy and surgical resection or strictureplasty. An increasingly more common middle ground approach is colonoscopic balloon dilation (BD). The aim of this study was to examine the efficacy and complication rate of BD in a population of patients with symptomatic strictures. Retrospectively, all patients in our local IBD practice who underwent colonoscopic balloon dilation with a diagnosis of a symptomatic Crohn’s stricture between January 2006 and March 2016 were reviewed. Demographic data were collected and technical and clinical success determined to compare the results between primary and anastomotic strictures. Technical success was defined as subjective improvement in the stricture and the ability to pass the scope through it. Clinical success was defined as subjective clinical improvement at follow up 3 months or more after the procedure. Pearson’s chi-squared test was used to compare relative efficacy. 98 patients were identified with a total of 108 strictures dilated. The mean age of the patients was 45.2 years (range 20–79). 64.3% of the patients were females. 51.9% of the strictures were anastomotic. 32.4% were on immunomodulators (methotrexate, azathioprine or 6-mercaptopurine) and 25.9% on anti-TNF therapy at the time of the dilation. 30.6% were on steroids. An adult Olympus colonoscope (diameter 13.2 mm) was used in 86.1% of cases. 31.5% of strictures were estimated to be less than 10 mm in diameter. 82.4% of the strictures were impassable prior to dilation. The most common balloon diameter was 15 mm (24.1%) with a median dilation diameter of 16.5 mm. Technical success was achieved in 62%. Clinical success was achieved in 84.3%. Complications were observed in one patient (post colonoscopy bleeding requiring hospitalization for supportive measures and blood transfusion). Comparison of primary and anastomotic strictures demonstrated a statistically significant difference in technical success (73.1% vs 51.8%, p=0.023) but not clinical success (86.5% vs 82.1% p=0.531). Colonoscopic balloon dilation of both primary and anastomotic strictures is feasible and appears to be clinically efficacious in a majority of patients with symptomatic primary and anastomotic Crohn’s strictures. Complication rates, though not insignificant, appear to be acceptably low. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".