Abstract
S1359 Needle-Knife Stricturotomy (NKSt) for IBD-Related Strictures: A Single-Center Experience
The American journal of gastroenterology, Vol.119(10S), pp.S970-S971
10/2024
DOI: 10.14309/01.ajg.0001034804.99496.5c
Abstract
Introduction:
In recent years, various endoscopic treatment options have emerged for managing strictures associated with inflammatory bowel disease (IBD) and non-IBD conditions. Among these, needle knife stricturotomy (NKSt) has gained attention as a novel approach. By avoiding or delaying surgery, NKSt offers a potential alternative for patients with fibrotic strictures. In this study, we delve into our tertiary care centre’s experience with NKSt, exploring its efficacy and role in treating strictures.
Methods:
A retrospective chart review was performed on patients with Crohn’s disease who underwent NKSt at our tertiary care center between 2018 to 2023. Retrospective demographic, clinical, and procedure-specific information was extracted from the electronic medical record. Patients with strictures related to a disease other than IBD were excluded from the study.
Results:
In this study involving 48 patients, 30 (62.5%) had anastomotic strictures (AS), while 18 (37.5%) exhibited non-anastomotic strictures (NAS). Demographically, both populations were comparable across all variables assessed. Treatment approaches varied; anti-TNF agents were predominantly used in the AS cohort. (Table 1) At the time of NKSt, steroids were being used by 4 (22.2%) NAS patients and 7 (23.3) AS patients. Abdominal pain was the chief symptom for both groups (NAS: 61%; AS 56.7%) The colon was identified as the most frequent stricture location in both subgroups (AS: 33.3%, NAS: 27.7%). Non-anastomotic strictures had a marginally greater mean length (1.58 ± 0.36 cm) compared to AS (0.9 ± 0.5 cm). In addition to the NSKt, balloon dilatation was performed concurrently on 5 NAS patients (28%) and 6 AS patients (20%). No peri-procedural complication was observed in either group. Symptom recurrence was observed in 22% of NAS cases and 23% of AS cases post-procedure. Subsequent endoscopic intervention was necessary for half of the participants; however, surgical intervention was not required for any patient within either group.
Conclusion:
In recent times endoscopic stricturotomy has emerged as a safe and effective way of treating AS, and non-AS. The rates of complications in our study were low and the patients had an uneventful procedural course. Previous case series have demonstrated the efficacy of this intervention in strictures < 3 cm such as in our study. With a small sample size being a limitation of this study, we aim to gather more data to increase generalizability and compare NKSt with other endoscopic methods (Figure 1).
Details
- Title: Subtitle
- S1359 Needle-Knife Stricturotomy (NKSt) for IBD-Related Strictures: A Single-Center Experience
- Creators
- Muhammad Z. Khan - Henry Ford Health SystemAmmad Javaid Chaudhary - Henry Ford Health SystemMuhammad Shahzil - Penn State Milton S. Hershey Medical CenterAli Jaan - Rochester General HospitalAbdullah Sohail - University of IowaAhila Manivannan - Henry Ford Health SystemHamza Asif - Khyber Teaching HospitalAbdulmalik Saleem - Henry Ford Health SystemMuhammad Saad Faisal - Henry Ford Health SystemSyed Ahmad Adil - Henry Ford Health SystemSpandana Alluri - Henry Ford Health SystemMuhammad Salman Faisal - Henry Ford Health SystemJason Schairer - Henry Ford Health System
- Resource Type
- Abstract
- Publication Details
- The American journal of gastroenterology, Vol.119(10S), pp.S970-S971
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- DOI
- 10.14309/01.ajg.0001034804.99496.5c
- ISSN
- 0002-9270
- eISSN
- 1572-0241
- Language
- English
- Date published
- 10/2024
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984740160102771
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