Endoscopic Stricturotomy for the Treatment of Inflammatory Bowel Diseases' Ileocolonic Strictures: A Systematic Review

Abstract

Background and aims: Inflammatory and fibrotic strictures are common in inflammatory bowel diseases (IBD) and are challenging conditions to manage. Endoscopic stricturotomy (ESt) is considered as an emerging treatment option. We aimed to summarise evidence on the efficacy of ESt for the treatment of IBD-associated strictures.

Methods: The databases Pubmed and Cochrane Controlled Trial Register were searched to identify all reports related to ESt in IBD, published till January 2025. A systematic review was conducted identifying clinical and endoscopic improvement.

Results: 18 studies involving 317 patients were included in the analysis. ESt improved symptoms in 64.2% of patients after a median follow-up of 7.8 months. Endoscopic improvement was detected in 22% of patients after 9 months. Mean length of treated strictures was 1.6 cm. Major adverse events resulted in 5.6% of patients treated by ESt.

Conclusions: Endoscopic stricturotomy seems to be an effective option for treatment of IBD' strictures. However further data is required to confirm the role of ESt in this setting.