Long-term results of endoscopic balloon dilation for treatment of colorectal anastomotic stenosis.
Surg Endosc
; 30(10): 4432-7, 2016 10.
Article
em En
| MEDLINE
| ID: mdl-26895912
ABSTRACT
BACKGROUND:
Despite standardized techniques, anastomotic complications after colorectal resection remain a challenging problem. Among those, anastomotic stricture is a debilitating outcome which often requires multiple interventions and which is prone to recur. The present series investigates the long-term results of endoscopic balloon dilation for stenotic colorectal anastomosis.METHODS:
Consecutive patients from a single institution who presented with an anastomotic stenosis after a colorectal resection were identified using a prospective clinical database. Medical records were systematically reviewed to detail patients' outcomes.RESULTS:
Over 17 years (1988-2015), 2361 consecutive patients underwent a colorectal anastomosis. Of those, 76 patients (3.2 %) suffered a symptomatic anastomotic stenosis within a median of 5 months (interquartile range (IQR) 2-13) of the index procedure. All stenoses were primarily treated by endoscopic balloon dilation. Median follow-up was 11 years (IQR 7-14). In half the patients, one to two attempts at endoscopic balloon dilation definitively relieved the stenosis. Overall, the median number of endoscopic balloon dilation required was 3 (IQR 2-3). Recurrence rates at 1 year, 3 year, and 5 year were 11, 22, and 25 %, respectively. Median time to recurrence was 12 months (IQR 3-24). Ultimately, two patients (2.6 %) underwent an operation due to failure of endoscopic treatment. All other patients (97.4 %) were treated successfully with endoscopic balloon dilation. A total of 12 patients (15.7 %) suffered a complication from endoscopic dilation. Of those, 11 were minor bleeding and one was a perforation at the level of the anastomosis. All complications were managed conservatively, and no emergency procedure was required as a consequence of attempted endoscopic balloon dilation.CONCLUSION:
Endoscopic balloon dilation is a safe approach to effectively relieve an anastomotic stenosis following a colorectal resection.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Neoplasias Colorretais
/
Recidiva Local de Neoplasia
Tipo de estudo:
Etiology_studies
/
Observational_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Surg Endosc
Assunto da revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Suíça