Abstract
Background
Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures.
Methods
Sixty patients (37 women; median age 63.6 years, range 22.6–81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up.
Results
The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3–60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0–144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation.
Conclusions
Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.
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Disclosures
Drs. Ivana Bravi, Davide Ravizza, Giancarla Fiori, Darina Tamayo, Cristina Trovato, Giuseppe De Roberto and Chiara Genco have no conflicts of interest or financial ties to disclose. Dr. Crosta is consultant and teacher of Pentax Education Center in Milan. The European Institute of Oncology receives an unrestricted grant by Pentax Italia to undertake research activities and training programs.
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Bravi, I., Ravizza, D., Fiori, G. et al. Endoscopic electrocautery dilation of benign anastomotic colonic strictures: a single-center experience. Surg Endosc 30, 229–232 (2016). https://doi.org/10.1007/s00464-015-4191-0
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DOI: https://doi.org/10.1007/s00464-015-4191-0