Evidence map›Paper›PMID 26358739›Full record

SynthesisAlimentary pharmacology & therapeutics2015

Systematic review with meta-analysis: endoscopic balloon dilatation for Crohn's disease strictures.

P S Morar, O Faiz, J Warusavitarne, S Brown, R Cohen, D Hind, J Abercrombie, K Ragunath, D S Sanders, I Arnott and 4 more

2 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Alimentary pharmacology & therapeutics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 50 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 6 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04330846 narecruitingnot on this mapstarted 2022, after this paper: background citation

Prospective Multicenter Randomized Comparative Study of the Treatment of de Novo Stenosis in Crohn's Disease. Endoscopic Treatment (Self-expanding Metal Prosthesis/Ballon Dilation) vc Surgical Resection (ENDOCIR STUDY)

TypeinterventionalSponsorGrupo Espanol de Trabajo en Enfermedad de Crohn y Colitis UlcerosaRan2022 to 2027Enrolled40ConditionsCrohn DiseaseArmsSurgical resection
NCT06036680 unknown statusnot on this mapstarted 2022, after this paper: background citation

Long-term Follow-up ProtDilat Study; Comparative Prospective Multicenter Randomized Study of Endoscopic Treatment of Stenosis in Crohn´s Disease: Self-expandable Metal Stent vs. Endoscopic Balloon Dilatation

TypeobservationalSponsorHospital Mutua de TerrassaRan2022 to 2023Enrolled80ConditionsCrohn Disease, Stenosis
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 134 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Efficacy of Endoscopic Dilation of Gastroduodenal Crohn's Disease Strictures: A Systematic Review and Meta-Analysis of Individual Patient Data.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2019
    Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Review
  10. Observational
  11. Article
  12. Article
  13. Large Bowel Obstruction: Etiologies, Diagnosis, and Management.Clinics in colon and rectal surgery · 2024
    Review
  14. Article
  15. Imaging of Strictures in Crohn's Disease.Life (Basel, Switzerland) · 2023
    Review
  16. Article
  17. Article
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 1 country.

P S MorarDepartment of Surgery and Cancer, Imperial College, London, UK.
O FaizDepartment of Surgery and Cancer, Imperial College, London, UK.
J WarusavitarneDepartment of Surgery and Cancer, Imperial College, London, UK.
S BrownSheffield Teaching Hospitals, Sheffield, UK.
R CohenUniversity College Hospital, London, UK.
D HindClinical Trials Research Unit, University of Sheffield, Sheffield, UK.
J AbercrombieNIHR Nottingham Digestive Disease Biomedical Research Unit, Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK.
K RagunathNIHR Nottingham Digestive Disease Biomedical Research Unit, Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK.
D S SandersSheffield Teaching Hospitals, Sheffield, UK.
I ArnottDepartments of Gastroenterology and Colorectal Surgery, Western General Hospital, Edinburgh, UK.
G WilsonDepartments of Gastroenterology and Colorectal Surgery, Western General Hospital, Edinburgh, UK.
S BloomUniversity College Hospital, London, UK.
N ArebiDepartment of Surgery and Cancer, Imperial College, London, UK.
Crohn's Stricture Study (CroSS) Group
Imperial College London · GBSheffield Teaching Hospitals NHS Foundation Trust · GBSt Mark's Hospital · GBUniversity College Hospital · GBWestern General Hospital · GBNottingham University Hospitals NHS Trust · GBQueen's Medical Centre · GBUniversity of Sheffield · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic balloon dilatation (EBD) is recognised treatment for symptomatic Crohn's strictures. Several case series report its efficacy. A systematic analysis for overall efficacy can inform the design of future studies.

aimTo examine symptomatic (SR) and technical response (TR) and adverse events (AE) of EBD. Stricture characteristics were also explored.

methodsA systematic search strategy of COCHRANE, MEDLINE and EMBASE was performed. All original studies reporting outcomes of EBD for Crohn's strictures were included. SR was defined as obstructive symptom-free outcome at the end of follow-up, TR as post-dilatation passage of the endoscope through a stricture, and adverse event as the presence of complication (perforation and/or bleeding). Pooled event rates across studies were expressed with summative statistics.

resultsTwenty-five studies included 1089 patients and 2664 dilatations. Pooled event rates for SR, TR, complications and perforations were 70.2% (95% CI: 60-78.8%), 90.6% (95% CI: 87.8-92.8%), 6.4% (95% CI: 5.0-8.2) and 3% (95% CI: 2.2-4.0%) respectively. Cumulative surgery rate at 5 year follow-up was 75%. Pooled unweighted TR, SR, complication, perforation and surgery rates were 84%, 45%, 15%, 9% and 21% for de novo and 84%, 58%, 22%, 5% and 32% for anastomotic strictures. Outcomes between two stricture types were no different on subgroup meta-analysis.

conclusionsEfficacy and complication rates for endoscopic balloon dilatation were higher than previously reported. From the few studies with 5 year follow-up the majority required surgery. Future studies are needed to determine whether endoscopic balloon dilatation has significant long-term benefits.

Indexed as

Constriction, PathologicCrohn DiseaseDilatationEndoscopyHumansTreatment Outcome

Identifiers

PMID26358739
OpenAlexW2162184641

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.