S1621 Endoscopic Balloon Dilation Within 2 Years of Ileocolonic Resection in Crohn’s Disease Is Associated With Increased Corticosteroid Use, Hospitalizations, and Repeat Surgery

Introduction: Endoscopic balloon dilation (EBD) is commonly used to manage Crohn’s disease (CD) strictures. The long-term impact of EBD within 2 years of ileocolonic resection is unknown. Methods: We conducted a retrospective cohort study using the TriNetX multi-institutional electronic health record database. Adult patients with CD who underwent ileocolonic resection were identified using Current Procedural Terminology and International Classification of Diseases-10 procedure codes. Patients were stratified into 2 groups: those who underwent EBD within 2 years of surgery and those who did not. Propensity score matching (1:1) was performed to balance cohorts on demographics, comorbidities, CD disease characteristics, and medication history. Outcomes were assessed from 30 days to 5 years following the index date. Adjusted hazard ratios (aHRs) were calculated using Cox proportional hazards models. Results: After matching, 199 patients were included in each group (EBD vs no EBD). The EBD group had higher rates of corticosteroid use (52.3% vs 37.2%; aHR 1.65, 95% CI 1.23–2.23, P = 0.001), hospitalization (47.7% vs 33.2%; aHR 1.53, 95% CI 1.11–2.09, P = 0.008), and repeat bowel surgery (25.6% vs 13.6%; aHR 1.96, 95% CI 1.23–3.12, P = 0.004). ED visit rates were higher in the EBD group but not statistically different between groups (39.2% vs 36.2%; aHR 1.03, 95% CI 0.75–1.42; P = 0.849). The specific type of postoperative stricture (e.g., anastomotic vs primary CD) could not be determined. Conclusion: CD patients who underwent EBD within 2 years of ileocolonic resection had increased rates of corticosteroid use, hospitalization, and surgical resection. Patients requiring EBD postoperatively should undergo closer surveillance.