1Department of Medicine, Shiga University of Medical Science, Otsu, Japan
2Division of Clinical Nutrition, Shiga University of Medical Science, Otsu, Japan
3Department of Comprehensive Internal Medicine, Shiga University of Medical Science, Otsu, Japan
© Copyright 2020. Korean Association for the Study of Intestinal Diseases. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
FINANCIAL SUPPORT
The authors received no financial support for the research, authorship, and/or publication of this article.
CONFLICT OF INTEREST
The prototype single-balloon enteroscopes were provided on loan, free of charge, by the Olympus Corporation. No other potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTION
Conceptualization: Morita Y, Bamba S. Formal analysis: Morita Y, Bamba S. Investigations: all authors. Writing - original draft: Morita Y. Writing - review and editing: Morita Y, Bamba S, Inatomi O, Takahashi K, Imai T. Supervision: Andoh A. Approval of final manuscript: all authors.
Factor |
Univariate analysis |
Multivariate analysis |
||
---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | |
Male sex | 0.830 (0.304–2.267) | 0.715 | 0.560 (0.171–1.837) | 0.339 |
Age at diagnosis | 0.987 (0.947–1.028) | 0.506 | 0.994 (0.949–1.042) | 0.813 |
BMI | 0.989 (0.867–1.128) | 0.861 | - | |
Smoking | 0.867 (0.255–2.949) | 0.820 | - | |
Disease phenotype B2 | 0.840 (0.348–2.029) | 0.698 | - | |
Disease location L1 | 1.555 (0.644–3.753) | 0.328 | - | |
Perianal lesion present | 1.615 (0.679–3.84) | 0.279 | - | |
History of surgery | 1.807 (0.728–4.483) | 0.202 | 3.598 (0.827–15.663) | 0.088 |
Failure of EBD | 18.927 (7.445–48.116) | 0.001a | 17.276 (3.546–84.159) | < 0.001a |
Symptomatic bowel obstruction | 2.118 (0.624–7.195) | 0.230 | - | |
Serum albumin (mg/dL) | 0.693 (0.287–1.674) | 0.415 | - | |
Serum CRP (mg/dL) | 1.287 (0.920–1.800) | 0.142 | 1.008 (0.646–1.572) | 0.974 |
CDAI | 1.011 (1.005–1.016) | 0.001a | 1.007 (1.000–1.014) | 0.039a |
Use of thiopurines | 0.535 (0.180–1.591) | 0.261 | - | |
Use of anti-TNF-α antibody | 1.622 (0.683–3.851) | 0.274 | - | |
Prototype SBE | 1.652 (0.677–4.027) | 0.270 | - | |
EBD for multiple strictures | 0.554 (0.224–1.374) | 0.203 | 0.374 (0.111–1.265) | 0.114 |
De novo type of strictures | 1.141 (0.383–3.407) | 0.814 | - | |
Long stricture (≥ 2 cm) | 11.258 (4.109–30.845) | 0.001a | 4.737 (1.290–17.388) | 0.019a |
Characteristic | Value (n = 94) |
---|---|
Sex (male/female) | 77/17 |
Age at diagnosis (yr) | 28.8 ± 13.0 |
Age at first EBD (yr) | 37.0 ± 12.4 |
BMI (kg/m2) | 21.3 ± 3.3 |
Smoking (yes/no) | 13/81 |
Age at diagnosis (A1/A2/A3) | 8/72/14 |
Disease phenotype at first EBD (B1/B2/B3) | 16/62/16 |
Disease location at first EBD (L1/L3) | 52/42 |
Perianal lesion present (yes/no) | 30/64 |
History of surgery (yes/no) | 48/46 |
Success of EBD (yes/no) | 83/11 |
Symptoms of obstruction before EBD (yes/no) | 71/23 |
Serum albumin (g/dL) | 3.8 ± 0.5 |
Serum CRP (mg/dL) | 0.6 ± 1.0 |
CDAI at first EBD (point) | 127.3 ± 76.8 |
Concomitant treatments | |
Thiopurine (yes/no) | 29/65 |
Anti-TNF-α antibody (yes/no) | 43/51 |
Scope used for initial EBD | |
Conventional SBE | 44 |
Prototype SBE | 50 |
Stricture site | |
Single (%) | 49 |
Multiple (%) | 45 |
2 | 22 |
3 | 11 |
≥4 | 12 |
De novo type of strictures (yes/no) | 77/17 |
Stricture length (cm) | 1.3 ± 0.9 |
Long stricture (≥ 2 cm, yes/no) | 26/68 |
Factor | Univariate analysis |
Multivariate analysis |
||
---|---|---|---|---|
HR (95% CI) | P-value | HR (95% CI) | P-value | |
Male sex | 0.830 (0.304–2.267) | 0.715 | 0.560 (0.171–1.837) | 0.339 |
Age at diagnosis | 0.987 (0.947–1.028) | 0.506 | 0.994 (0.949–1.042) | 0.813 |
BMI | 0.989 (0.867–1.128) | 0.861 | - | |
Smoking | 0.867 (0.255–2.949) | 0.820 | - | |
Disease phenotype B2 | 0.840 (0.348–2.029) | 0.698 | - | |
Disease location L1 | 1.555 (0.644–3.753) | 0.328 | - | |
Perianal lesion present | 1.615 (0.679–3.84) | 0.279 | - | |
History of surgery | 1.807 (0.728–4.483) | 0.202 | 3.598 (0.827–15.663) | 0.088 |
Failure of EBD | 18.927 (7.445–48.116) | 0.001 |
17.276 (3.546–84.159) | < 0.001 |
Symptomatic bowel obstruction | 2.118 (0.624–7.195) | 0.230 | - | |
Serum albumin (mg/dL) | 0.693 (0.287–1.674) | 0.415 | - | |
Serum CRP (mg/dL) | 1.287 (0.920–1.800) | 0.142 | 1.008 (0.646–1.572) | 0.974 |
CDAI | 1.011 (1.005–1.016) | 0.001 |
1.007 (1.000–1.014) | 0.039 |
Use of thiopurines | 0.535 (0.180–1.591) | 0.261 | - | |
Use of anti-TNF-α antibody | 1.622 (0.683–3.851) | 0.274 | - | |
Prototype SBE | 1.652 (0.677–4.027) | 0.270 | - | |
EBD for multiple strictures | 0.554 (0.224–1.374) | 0.203 | 0.374 (0.111–1.265) | 0.114 |
De novo type of strictures | 1.141 (0.383–3.407) | 0.814 | - | |
Long stricture (≥ 2 cm) | 11.258 (4.109–30.845) | 0.001 |
4.737 (1.290–17.388) | 0.019 |
Characteristic | Conventional SBE only (n = 6) | Prototype SBE only (n = 31) | Conventional and prototype SBE (n = 26) |
---|---|---|---|
Sex (male/female) | 4/2 | 27/4 | 19/7 |
Age at diagnosis (yr) | 32.3 ± 17.1 | 26.7 ± 11.0 | 29.1 ± 9.8 |
Age at first EBD (yr) | 40.5 ± 15.5 | 36.3 ± 12.3 | 38.3 ± 7.6 |
BMI (kg/m2) | 21.3 ± 3.8 | 20.8 ± 3.1 | 21.3 ± 3.1 |
Smoking (yes/no) | 0/6 | 5/26 | 4/22 |
Conventional → prototype | - | - | 23 |
Prototype → conventional | - | - | 3 |
Age at diagnosis (A1/A2/A3) | 1/4/1 | 3/25/3 | 1/22/3 |
Disease phenotype at first EBD (B1/B2/B3) | 0/6/0 | 3/23/5 | 1/20/5 |
Disease location at first EBD (L1/L3) | 3/3 | 19/12 | 17/9 |
Perianal lesion (yes/no) | 0/6 | 14/17 | 5/21 |
History of surgery (yes/no) | 3/3 | 16/15 | 15/11 |
Success of EBD (yes/no) | 5/1 | 29/2 | 26/0 |
Symptoms of obstruction before EBD (yes/no) | 6/0 | 20/11 | 24/2 |
Interval period (day) | 353.8 ± 188.9 | 625.7 ± 440.1 | 847.8 ± 765.9 |
Concomitant treatments | |||
Any thiopurine (yes/no) | 2/0 | 13/18 | 6/18 |
Anti-TNF-α antibody (yes/no) | 2/0 | 15/16 | 14/12 |
Stricture site | |||
Single (%) | 4 | 17 | 13 |
Multiple (%) | 2 | 14 | 13 |
2 | 1 | 5 | 6 |
3 | 1 | 7 | 4 |
≥4 | 0 | 2 | 3 |
Values are presented as mean±SD. EBD, endoscopic balloon dilatation; A1, ≤16 years; A2, 17–40 years; A3, >40 years; B1, non-stricturing, non-penetrating; B2, stricturing; B3, penetrating; L1, ileal; L3, ileocolonic; SBE, single-balloon enteroscopy.
Significant factor. B2, stricturing; L1, ileal; EBD, endoscopic balloon dilatation; SBE, single-balloon enteroscopy.
Values are presented as mean±SD. SBE, single-balloon enteroscopy; EBD, endoscopic balloon dilatation; A1, ≤16 years; A2, 17–40 years; A3, >40 years; B1, non-stricturing, non-penetrating; B2, stricturing; B3, penetrating; L1, ileal; L3, ileocolonic.