Long-term quality of life after endoscopic dilation of strictured colorectal or colocolonic anastomoses

Abstract

Health-related quality of life is significantly impaired at long-term after standard balloon-dilation of benign anastomotic colorectal strictures as a result of gastrointestinal symptoms and stress by treatment. This impairment might be related to the fact that an anastomotic diameter > or = 13 mm, although commonly used to define successful endoscopic treatment, is insufficient to provide long-term symptom relief in some patients, or to other, yet to be identified, factors.

Risk factors for colorectal anastomotic stenoses and their impact on quality of life: what are the lessons to learn?

“…Health‐related quality of life was also found to be significantly impaired in those patients with respect to a matched surgical control group. Using the Gastrointestinal Quality of Life Index to measure patients’ impairment, they found that the ‘gastrointestinal symptoms’ and the ‘stress of medical treatment’ [9] subscales were significantly worse in the stenosis patients with respect to the controls. Although our study was limited because it used a more generic quality‐of‐life questionnaire (SF‐36) and only telephone interviews, our findings seem to confirm these results.…”

“…Surgical treatments consist of radial diathermy incisions, redo anastomosis or less frequently stoma construction. Health‐related quality of life in these patients appears to be significantly impaired even years after surgery [9].…”

Les dilatations par endoscopie

“…À l'exception des sténoses rectales basses, le recours aux ballonnets hydrostatiques est la règle, sans dépasser des diamètres de 18 mm. Il est classique de considérer que l'objectif à atteindre est de rendre la sténose franchissable par un coloscope standard (environ 13 mm), mais une étude récente a montré que malgré les dilatations, la qualité de vie des patients restait altérée en raison des troubles digestifs persistants [3].…”

Complication après résection rectale pour cancer conservant la continuité digestive : approche chirurgicale

“…Cependant, ce bénéfice à long terme des dilatations de sténoses bénignes est inconstant. Nguyen-Tang et al [20] rapportent ainsi une qualité de vie diminuée chez les patients qui ont reçu une dilatation endoscopique de sténose colorectale bénigne. Les auteurs considèrent que le diamètre doit être significatif pour pouvoir parler de succès.…”