Background and Aims

Fistulas in patients with inflammatory bowel disease (IBD) pose a key challenge in the management of these patients. We aimed to describe a novel endoscopic method to treat patients with IBD who have fistulas.

Methods

A cohort of 29 consecutive patients with fistulas and IBD were identified in the registry of our interventional IBD unit. An endoscopic fistulotomy with needle-knife was performed. The primary outcome was healing of the fistula without the need for surgical intervention.

Results

A total of 29 patients underwent endoscopic fistulotomy; and the mean (± standard deviation) age of patients undergoing the procedure was 44.2 ± 14.6 years. Thirteen patients were male (44.8%), and 16 were female (55.2%). Twenty-six patients (89.6%) achieved complete resolution of the fistula as confirmed by endoscopy with a guidewire and/or cross-sectional abdominal imaging, with 10 patients (34.4%) requiring a single endoscopic treatment session. Three patients (10.3%) had a persistent fistula and required surgical intervention. One patient had postoperative bleeding requiring blood transfusion and hospitalization.

Conclusion

Endoscopic fistulotomy with a needle-knife appears to be safe and effective in treating IBD-related fistulas.

中文翻译：

---

炎症性肠病的内镜下纤维网膜切开术（视频）

背景和目标

炎症性肠病（IBD）患者的瘘管对这些患者的治疗提出了关键挑战。我们旨在描述一种新型的内窥镜治疗患有瘘管的IBD患者的方法。

方法

在我们的介入性IBD病房的登记册中确定了29例连续的瘘管和IBD患者队列。内窥镜下用针刀切开。主要结果是无需手术干预即可治愈瘘。

结果

共有29例患者接受了内镜下镜下切开术；接受该手术的患者的平均年龄（±标准差）为44.2±14.6岁。男性13例（44.8％），女性16例（55.2％）。经引导线和/或腹部横截面内窥镜检查证实，有26例患者（占89.6％）达到了瘘管的完全消融，其中10例患者（占34.4％）需要进行一次内镜治疗。3例（10.3％）患有持续性瘘管，需要进行手术干预。一名患者术后出血，需要输血和住院。

结论

内镜下用针刀进行纤维网切开术在治疗IBD相关性瘘管方面似乎是安全有效的。