A111 LONG-TERM SAFETY AND OUTCOMES OF COLONOSCOPIC BALLOON DILATION FOR STRICTURING CROHN’S DISEASE
Bibliographic record
Abstract
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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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".