Abstract
Anastomotic stenosis after colorectal surgery is usually considered low-rate complication and often is under-reported in most studies. Few data are available on management strategies. The aim of the study was to assess the prevalence of stenosis after stapled colorectal anastomosis, performed either in elective or emergent setting, for benign or malignant disease, and to evaluate treatment profiles. This retrospective study was a survey conducted in a large Italian North-Eastern area including three regions (Triveneto), over a 12-month period (January–December 2015). Patients’ characteristics and surgical technique details were recorded, along with data on the prevalence of stenosis and its treatment. Patients with mid or low rectal resection and/or neoadjuvant chemo-radio therapy and/or diverting stoma were excluded. The study was promoted by the Italian Association of Hospital Surgeons (ACOI) and the Society of Surgeons of the Triveneto Region. Twenty-eight surgical units were enrolled in the survey, accounting for over 1400 patients studied. Fifty percent of the units performed laparoscopically > 70% of the colorectal resections and 7.5% of the procedures were emergent. Less than 60% of the units planned regular endoscopic follow-up after colorectal resection. Anastomotic stricture was recorded in 2% of the patients; 88% of the stenoses were diagnosed within 6 months from surgery. Only one anastomotic stricture required re-do surgery. The CANSAS study confirms that colorectal anastomotic stenosis is low-rate—but still present—complication. Treatment strategies vary according to surgeons’ and endoscopists’ preferences. Commonly endoscopic dilatation is preferred, but re-do surgery is required in some cases.
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Acknowledgements
Collaborators of the CANSAS study working group (Colorectal ANastomotic Stenosis After Surgery). S Vigna, A Mazzeo, D Coco, F Agresta, E Finotti, M Antoniutti, S Carnio, A Elio, M Brunelli, G Ruffo, E Bertocchi, D Parini, L Losacco, F Poli, G Santoro, M Massani, C Ruffolo, E Cian, L Zanatta, M Genna, A Ballarin, M Rebonato, M Fontana, G Moretto, H Impellizzeri, R Merenda, G Margani, S Merigliano, N Baldan, P Ubiali, A Braini, A Balani, M Kosuta, A Infantino, G Giacomel, G Armatura, S Patauner, N de Manzini, S Palmisano, M Sorrentino, M Brizzolari, C Belluco, M Olivieri, E Lauro, G Scudo, P Valduga, A Brolese, G Pignata, J Andreucetti, A Caruso, F Zappalà.
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Drs. Alberto Sartori, Maurizio De Luca, Valentino Fiscon, Mauro Frego, the CANSAS study working group and Giuseppe Portale have no conflict of interest to disclose.
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The study was conducted according to the Helsinki Declaration. The study was approved by the local Ethics Committee.
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Patients gave their consent to have their data collected for scientific purposes.
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Collaborators of the CANSAS study working group (Colorectal ANastomotic Stenosis After Surgery) are given in the acknowledgements section.
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Sartori, A., De Luca, M., Fiscon, V. et al. Retrospective multicenter study of post-operative stenosis after stapled colorectal anastomosis. Updates Surg 71, 539–542 (2019). https://doi.org/10.1007/s13304-018-0575-8
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DOI: https://doi.org/10.1007/s13304-018-0575-8