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Surg Endosc. 2003 Jul;17(7):1110-3. Epub 2003 May 6.

Endoscopic treatment of postoperative colorectal anastomotic strictures.

Author information

1
Institute for Surgical Endoscopy, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany. katrin.suchan@chir.ma.uni-heidelberg.de

Abstract

BACKGROUND:

The postoperative development of benign colorectal anastomotic stricture remains a frequent and unsolved problem.

METHODS:

From 1996 until 2002, we analyzed 94 consecutive patients with postoperative colorectal anastomotic stenosis who were treated endoscopically.

RESULTS:

Sixty-eight patients were initially resected for malignant disease, and 26 patients for benign conditions. Most frequently, hydrostatic balloon dilatation was performed; in selected cases, it was combined with a laser or argon plasma coagulation (APC) incision, or a laser incision only. Dilatation was successful in 59% of patients resected for cancer and 88% resected for a benign condition. Complications developed in 17 patients (benign restenosis, perforation, abscess); they were significantly more frequent after initial cancer resection than after resection for a benign condition ( p < 0.05).

CONCLUSION:

High success and low complication rates make endoscopic dilatation the treatment of choice to avoid high-risk reoperations in patients with benign anastomotic stricture. The presence of stapler anastomosis, postoperative leakage, and/or radiotherapy does not significantly impede successful endoscopic dilatation.

PMID:
12728381
DOI:
10.1007/s00464-002-8926-3
[Indexed for MEDLINE]

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