Needle-knife stricturotomy in Crohn's-related anorectal strictures: a prospective study of long-term outcomes, safety profile, and risk factors for recurrence.

What To Know

This prospective single-center cohort study evaluated endoscopic needle-knife stricturotomy (NKSt) for primary high-grade anorectal strictures in Crohn’s disease, with median follow-up about 24 months.

The procedure had 100% immediate technical success and about 70% of patients reported symptomatic improvement at 3 months; recurrence requiring re-intervention occurred in 37% of patients during follow-up.

Multivariable analysis in the report identified longer stricture length and presence of an ostomy as factors associated with higher recurrence risk, while concurrent biologic therapy was associated with lower recurrence. The authors also observed a lower recurrence rate when NKSt was combined with bleomycin injection in univariable analysis.

The paper concludes NKSt appears effective and safe but that recurrence is common and that findings need validation in larger multicenter studies.

If you are considering NKSt, these results suggest short-term symptom benefit is common but recurrence remains a significant possibility, and features such as stricture length and ostomy status may influence outcomes.

Discuss with your specialist how local experience, concurrent medical therapy (including biologics), and adjunctive techniques like injection might affect expected results.