Balloon Dilatation of Benign Rectal Anastomotic Strictures – A Review

Abstract

Background: The occurrence of anastomotic stricture at the level of the rectum gives rise to three broad therapeutic options, namely major pelvic and abdominal revisional surgery, faecal diversion (stoma), or local revision by transanal approaches (including endoscopic and fluoroscopic). This article updates the current evidence and focuses on the results of the balloon dilatation technique. Methods: A Medline search was carried out using the search terms (dilatation OR dilatation) AND (stricture OR strictures OR stenosis OR stenotic) AND (rectum OR rectal). In an effort to lessen publication bias, articles included at least 10 patients who were consecutively referred for treatment. Results/Conclusion: This review would suggest that probably relatively short strictures have been chosen for balloon dilatation and that the results have had a very low major morbidity (0.45%) and mortality (0%) rate.

Efficacy and safety of endoscopic radial incision and cutting for benign severe anastomotic stricture after surgery for lower rectal cancer (with video)

“…6 Values are total number of cases with percents in parentheses, unless otherwise indicated. ISR, Intersphincteric resection; LAR, low anterior resection, RIC, radial incision and cutting.…”

Endoscopic radial incision and cutting method for refractory stricture of a rectal anastomosis after surgery

“…Especially when a stricture is located in the rectum, it may cause severe symptoms, for which several therapeutic options are available: endoscopic balloon dilation (EBD) [2], placement of a self-expandable metal stent [3], revisional surgery, and palliative colostomy. However, the best treatment has yet to be determined.…”

Dilatation of benign anastomotic strictures after colorectal surgery with bougies

“…It is usually seen in the early postoperative period [8]. In the aetiology, such factors as anastomotic leakages, radiotherapy, the presence of an ischaemic anastomosis, and anastomotic staples are specified [9,10]. There are publications that indicate increased incidence of stenosis after use of a stapler [4,6].…”