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Endoscopic treatment of postoperative colorectal anastomotic strictures

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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.

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Authors and Affiliations

  1. Institute for Surgical Endoscopy, Department of Surgery, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, D-68167 Mannheim, Germany

    K. L. Suchan, A. Muldner & B. C. Manegold

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  1. K. L. Suchan
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  2. A. Muldner
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  3. B. C. Manegold
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Correspondence to K. L. Suchan.

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Suchan, K., Muldner, A. & Manegold, B. Endoscopic treatment of postoperative colorectal anastomotic strictures . Surg Endosc 17, 1110–1113 (2003). https://doi.org/10.1007/s00464-002-8926-3

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