ReviewDiseases (Basel, Switzerland)2026
Efficacy and Safety of Endoscopic Strictureplasty and Stricturotomy for Crohn's Disease-Associated Strictures: A Systematic Review and Current Perspective.
Review in Diseases (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
objectivesStrictures are a major complication of Crohn's disease (CD) affecting up to 20% of patients at diagnosis. Endoscopic balloon dilation (EBD) is the first-line endoscopic approach; however, it entails complications and a need for reintervention. Endoscopic stricturotomy (ESt) and stricturoplasty (ESTx) are promising alternatives. This review aims to provide an up-to-date and comprehensive assessment of their efficacy and safety in CD-associated strictures.
methodsA literature search was performed until August 2025. Primary outcomes were clinical and technical success. Secondary outcomes included adverse events, additional endoscopic or surgical treatments, medication escalation, emergency department visits and hospitalization following intervention. A minimum of four studies were required for meta-analysis, and pooled estimates were calculated using random-effects meta-analysis. Study quality was assessed using CASP checklist.
resultsFifteen studies including 1050 IBD patients (470 CD) were included. Strictures were short (0.9-2.4 cm) and some had prior EBD (7.8-57.1%) or surgery (3.6-91%). Technical success of ESt ranged from 88% to 100% and clinical success from 50% to 96%. The bleeding rate was up to 11.8%, but perforation rate was mostly <2%. The need for additional intervention, endoscopic (18.2-66.6%) or surgical (0-18.2%), varied considerably. Additionally, ESTx's technical success ranged from 91.7% to 100% whereas clinical success ranged from 71.4% to 91%, with bleeding ranging from 5.2% to 8.8% and perforation from 0% to 3.4%. Similarly, the need for additional endoscopic procedures (7.1-57.1%) and surgery (9.5-25%) varied considerably.
conclusionsESt and ESTx are safe and effective for managing CD-related strictures, particularly when short, straight, accessible, fibrotic, anastomotic, or refractory to EBD.
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