Endoscopic electrocautery dilation of benign anastomotic colonic strictures: a single-center experience

Bravi, I.; Ravizza, Davide; Fiori, Giancarla; Tamayo, D.; Trovato, C.; Roberto, Giuseppe; Genco, Chiara; Crosta, C.

doi:10.1007/s00464-015-4191-0

Cited by 30 publications

(31 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ten original articles were considered appropriate to be included in this review article [ 4 - 13 ]. Three studies described the application of EECI: a case report from Germany [ 4 ], a case series from Korea [ 7 ] and a retrospective case series from Italy [ 9 ]. Three studies described an endoscopic electrocautery radial incision and cutting (RIC) technique: one case report from Brazil [ 5 ], a retrospective case series from Japan [ 8 ] and a prospective study from Italy [ 10 ].…”

Section: Resultsmentioning

confidence: 99%

“…The spectrum of surgical resections included those for malignant primary lesions, such as low anterior resection for rectosigmoid colon cancer and rectal cancer, intersphincteric resection for lower rectal cancer, hemicolectomy or subtotal colectomy [ 5 , 7 - 13 ]. Patients undergoing proctocolectomy with ileal-pouch anal anastomosis for ulcerative colitis, sigmoid resection for diverticulitis and volvulus, prophylactic proctocolectomy for familial adenomatous polyposis were also included by some studies in this review [ 4 , 6 , 9 , 10 ]. Stricture formation across all studies included occurred at the site of the surgical anastomosis [ 4 - 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…The references of pertinent studies were searched manually to identify additional relevant studies. The search yielded case reports [ 4 - 6 ], case series [ 7 - 9 ], and prospective studies [ 10 - 13 ]. The stricture etiology, characteristics and location, device details, procedure details, success rate, complications and limitations were reviewed for each study.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures

Jain¹,

Sandhu

Singhal

2017

aog

View full text Add to dashboard Cite

Benign anastomotic strictures can occur in up to 22% of patients who undergo colonic or rectal resection. Traditionally, surgery was the preferred method of treatment, but, over time, endoscopic techniques, such as balloon dilation, have become the preferred modality. However, a high stricture recurrence rate of up to 18-20% and the increased risk of perforation due to uncontrolled stretching are its major drawbacks. Endoscopic electrocautery incision (EECI) allows for controlled mucosal incision in predetermined locations of stricture. In this meta-analysis, we have summarized case reports, case series, retrospective studies and prospective studies describing the different endoscopic EECI techniques used for benign lower gastrointestinal tract anastomotic strictures. Our analysis showed that EECI, either alone or in combination with other modalities (e.g. balloon dilation, steroid injection or argon plasma coagulation) is an effective treatment option for both treatment-naïve and refractory short non-inflammatory strictures. The overall success rate for EECI-based therapy for benign colorectal stricture was 98.4%, with a stricture recurrence rate of 6.0%. No major adverse event (bleeding, infection or perforation) was reported. Only minor adverse events (abdominal pain) were reported in 3.8% of the population.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures

Jain¹,

Sandhu

Singhal

2017

aog

View full text Add to dashboard Cite

show abstract

“…Recent studies also highlighted the fact that electrocautery dilation is a safe and effective treatment for relieving obstruction caused by postsurgical strictures. Several studies reported promising results from a long-term follow-up (median, 35.5 months), suggesting that one session of electrocautery treatment appears to be sufficient and there are no reported recurrences and procedure-related complications (16,17). Given that this technique is easy to perform, does not require a dedicated device and is cost-effective, additional studies are required to determine whether this technique may serve as an alternative method for relieving acute obstruction caused by benign colonic strictures.…”

Section: Discussionmentioning

confidence: 99%

Observational study of colonoscopy techniques used for acute colorectal obstruction: A single-center experience

Chen

et al. 2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

The prevalence of acute colorectal obstruction at the hospital setting is high. There is need for improvement in the quality of colonoscopy for relieving obstruction. A retrospective, uncontrolled, open-label study was conducted, with the aim of documenting the causes of acute colorectal obstruction and the quality of colonoscopy practice in managing obstruction at a university hospital in China. A total of 61 adult patients with acute colorectal obstruction treated with urgent colonoscopy between February, 2011 and January, 2016 were identified at the Endoscopic Unit of Tongji Hospital (Wuhan, China). The technique success rate was the primary outcome. The etiology was mainly related to malignant diseases, including colorectal cancer in 53 patients (86.9%) and advanced peritoneal serous carcinoma leading to extrinsic colonic compression in 1 patient (1.6%). Benign causes of obstruction included foreign bodies in 3 patients (4.9%) and fecal impaction in 2 patients (3.3%); furthermore, anastomotic strictures were found in 2 patients (3.3%). The technique success rate was 98.4% (60/61). All colorectal cancer patients who underwent urgent colonoscopy were admitted to the Department of Surgery for placement of a self-expanding metallic stent; 1 patient who had an extracolonic malignancy underwent placement of a transanal colonoscopic decompression tube as palliative therapy and 2 patients with anastomotic strictures underwent endoscopic balloon dilation. Furthermore, colonoscopy was used for extracting the foreign body, as well as removing fecal stones in all the patients. In conclusion, urgent colonoscopy as a minimal invasive approach is associated with certain advantages for diagnosing and managing acute colorectal obstruction. Furthermore, experienced operators achieved a better outcome when managing colorectal obstruction.

show abstract

“…Other combined treatments give a steroid injection in the incisions to avoid relapse of the stricture. In 2016, Bravi et al [32] reported a series of 60 patients with diaphragm-like strictures no larger than 3 mm. At least 4 radial incisions were made with a needle sphincterotome with no other technique.…”

Section: Incisional Therapy (Eei: Endoscopic Electrocautery Incision)mentioning

confidence: 99%

Advances in the Treatment of Postsurgical Benign Colorectal Strictures

García¹,

Pedreño²,

DuránCampos³

et al. 2019

Endoscopy - Novel Techniques and Recent Advancements

View full text Add to dashboard Cite

Postsurgical benign colorectal strictures occur in up to 20% of patients who undergo colon or rectal resection. Traditionally, treatment has been surgical, but recent decades have seen the growing importance of an endoscopic approach, particularly balloon dilatation, which is now considered the first-line treatment for these benign strictures. However, balloon dilatation is associated with a recurrence of the stricture in up to 25% of cases. When this arises, one can opt for surgery aimed at performing a reanastomosis; a new intestinal anastomosis may be technically complex or even impossible, which would result in the patient requiring a permanent colostomy, with its consequent negative impact on quality of life. Accordingly, different endoscopic approaches have been evaluated for strictures refractory to balloon dilatation, such as the implant of self-expanding metallic stents, biodegradable stents, or incisional therapy, with variable results in efficacy.

show abstract

Endoscopic electrocautery dilation of benign anastomotic colonic strictures: a single-center experience

Abstract: Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.

Cited by 30 publications

References 12 publications

Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures

Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures

Observational study of colonoscopy techniques used for acute colorectal obstruction: A single-center experience

Advances in the Treatment of Postsurgical Benign Colorectal Strictures

Contact Info

Product

Resources

About