Colorectal Anastomotic Stenosis After Elective Laparoscopic Sigmoidectomy for Diverticular Disease: A Prospective Evaluation of 68 Patients

Abstract

Incidence of symptomatic anastomotic stenosis after elective laparoscopic sigmoidectomy is high (17.6 percent). No risk factor could be identified. Endoscopic dilatations were successful without complication in all cases. Regular rigid rectoscopy definitely should be part of the postoperative follow-up in symptomatic patients.

Retrospective Analysis Of Rectal Stenosis After Anterior Resections With Or Without Stapling: Rectal Stapling Is Not A “Thornless Rosary

“…The incidence of primary and technique-related complications of stapling anastomosis is reportedly between 2.4-32 % (Smith, 1981;Thiede et al, 1981;Ti et al, 1986;Petrassi et al, 1994;Shimada et al, 1996;De Salvo et al, 1997;Yu et al, 2000;Brigand et al, 2004;Pan et al, 2004;Ambrosetti et al, 2008;Sciume et al, 2008). In 1994, Fingerhut showed in a randomised clinical study that stapled anastomosis has four times more risk of stricture than hand sewn's.…”

“…The incidence of stenosis has been reported, however no certain risk factor has been clarified (Stahle et al, 1986;Shimada et al, 1996;Ambrosetti et al, 2008;). Gender (Bannura et al, 2004), ischemia, radiation and defunctionalisation (McKee and Pricolo, 2008), anastomotic leakage (Thiede et al, 1981;McKee and Pricolo, 2008) have been proposed as risk factors.…”

Balloon Dilatation of Benign Rectal Anastomotic Strictures – A Review

“…Only one study gave an overall incidence of stricture after rectal surgery of 7.34% (26/422) [15]. A second study looked specifically at patients who underwent laparoscopic sigmoid colectomy and found the incidence to be 17.6% (12/68) [4]. Hypothetically, if there were 50-200 anastomoses at the level of rectum performed per year within the referring populations of the institutions associated with the series presented in this review, then 2.1-8.6% of patients would have been referred for dilatation (405/(94 × 50 or 200) ×100).…”

“…A total of 12 articles were identified from the literature search [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. In addition, unpublished series from our institution were also included.…”

Complications of Colonoscopy

“…Two prospective studies with a total of 42 patients with benign colorectal anastomotic stenosis, not associated with Crohn's disease, who underwent 81 sessions of colonic dilation reported no procedure-related complications [78,79].…”