Management of colorectal anastomotic stricture with multidiameter balloon dilation: long-term results

Abstract

Background Postoperative colorectal anastomotic strictures are quite common. As such, many techniques have been available to address such a problem, one of which is endoscopic dilation. The aim of the present study was to evaluate the long-term outcomes following endoscopic dilation using a multidiameter balloon. Methods A retrospective study was conducted on patients with postoperative anastomotic stenosis treated with endoscopic dilation using a multidiameter balloon at our institution, in January 2005-December 2019 were retrospectively reviewed, excluding those with tumor recurrence. Perioperative factors, complications, and recurrence rates were analyzed. Results There were 40 patients, (22 males and 18 females, mean age 64.6 ± 10.7 years, range 33-84 years). The median follow-up period was 56 months (interquartile range 22.5-99 months). Only 1 complication occurred, micro-perforation due to guided wire injury, which was managed conservatively. Five (12.5%) patients developed restenosis and underwent repeat balloon dilation. None of the five recurrences required more aggressive management, such as redo anastomosis. Conclusions Endoscopic multidiameter balloon dilation is a safe and effective method for treating benign colorectal anastomotic strictures.

Clinical efficacy of endoscopic dilation combined with bleomycin injection for benign anastomotic stricture after rectal surgery

“…Every time the procedure was held for 3 minutes (mins). [ 8 ] Then 10 milliliter (ml) bleomycin (10 milligram (mg) of 1 mg/ml, Haizheng, Zhejiang, China) was injected into the anastomotic site (at the 3, 6, 9, and 12 o’clock positions) with an injection needle (INJ1-A1, Medwork GmbH, Höchstadt, Germany) in bleomycin group (shown in Fig. 1 ).…”

Transanal Minimally Invasive Surgery for Rectal Anastomotic Stenosis After Colorectal Cancer Surgery

“…Furthermore, only short-segment stenosis responds well to endoscopic dilation. 5,6 A self-expanding metal stent is a conservative treatment option with a high migration risk and a low clinical success rate. 7 Recently, EECI has been reported as an effective treatment for anastomotic stenosis with a high success rate and few adverse events.…”

Application of transurethral prostate resection instrumentation for treating rectal anastomotic stenosis: Case series

“…Endoscopic interventional therapy, such as balloon dilation, often requires multiple treatments to obtain satisfactory results. [ 6 ] However, benign stenosis may have a significant impact on quality of life, including changes in bowel habits, and lead to large intestinal obstructions. After diagnosis and exclusion of local recurrence, the current effective treatment methods are surgery and endoscopy, with endoscopic treatments being the first-line treatment option.…”