Needle-Knife Stricturotomy (NKSt) for IBD-Related Strictures: A Single-Center Experience
Recommended Citation
Khan MZ, Chaudhary AJ, Shahzil M, Jaan A, Sohail A, Manivannan A, Asif H, Saleem A, Faisal MS, Adil SA, Alluri S, Faisal MS, Schairer J. Needle-Knife Stricturotomy (NKSt) for IBD-Related Strictures: A Single-Center Experience. Am J Gastroenterol 2024; 119(10):S971-S972.
Document Type
Conference Proceeding
Publication Date
10-1-2024
Publication Title
Am J Gastroenterol
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).
Volume
119
Issue
10
First Page
S971
Last Page
S972
