For primary ileocolic structures in patients with Crohn’s disease (CD), endoscopic balloon dilation (EBD) is initially successful with minimal adverse events, although there is a high frequency of salvage surgery. This while initial ileocolic resection (ICR) is associated with a higher morbidity but a longer surgery-free interval. The retrospective study compared post-procedure morbidity and surgery-free survival among 258 patients with primary stricturing ileo (colic) CD initially treated with primary EBD (n=117) or ICR (n=258) from 2000 through 2016. Researchers found:

• Post-procedural complications occurred in 4.7% of patients treated with EBD and salvage surgery was required in 44.4% of patients.
• Factors associated with reduced surgery-free survival among patients who underwent EBD included increased stricture length, ileocolonic vs ileal disease, and decreased interval between EBD procedures.
• Patients treated with ICR were associated with more common postoperative adverse events but reduced need for secondary surgery and significantly longer surgery-free survival.