W1118 Experience with Delayed-Release Mesalamine for Active Crohn's Disease (CD)

symptomatic strictures (4 patients had two strictures), which were located as follows: primitive 10 (duodenal 1, ileal 2, anal 7), anastomotic 36 (ileo-colonic 31, ileo-rectal 5). The mean stricture length was 36 mm. The mean follow-up period was 25.3 months (range, 260 months). Dilations were performed using a Rigiflex through-the-scope (TTS) balloon to a maximum dilation of 20 mm. Technical success was defined as the ability of the scope to overcome the stricture after dilation. Success rate was claimed if a patient remained asymptomatic and did not require surgery or further endoscopic dilation, following technical success. Actuarial curves of clinical recurrence was obtained by Kaplan-Meier method. Results A total of 81 TTS balloon dilations were performed for 46 symptomatic strictures in 42 patients. Technical success was achieved in 65 of 81 procedures (80%). The 1-2-3 years cumulative relapse-free rates were respectively: 77.6% (95% CI 0.60-0.88), 58.4% (95% CI 0.38-0.74), and 51.1% (95%, CI 0.29-0.69). After technical success, 6 patients had a second dilation and 7 had more than two dilations for clinical recurrence. Four patients were operated on within one year: one for persistent symptomatic duodenal stricture due to neoplasm, one for concomitant fistulas, two for persistent obstructive symptoms, following the technical failure of dilation. There were no complications related to the endoscopic procedures. Conclusions Endoscopic balloon dilation of symptomatic CD strictures may achieve clinical benefit in many patients and it is a temporary alternative to surgery in the management of disease. Dilation may be repeated in recurrent intestinal obstructions. The procedure appears safe without morbidity.