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

Harada, Kensuke; Hiraoka, Sakiko; Kawahara, Yoshiro; Kondo, Yoshitaka; Okada, Hiroyuki

doi:10.1055/s-0034-1392861

Cited by 9 publications

(11 citation statements)

References 5 publications

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“…We successfully conducted RIC in five CD patients with intestinal strictures. There are some case reports regarding RIC for colorectal strictures [7][8][9] after surgery for colorectal cancers. However, there is only one report about endoscopic dilation resembling RIC for CD intestinal stricture [10].…”

Section: Discussionmentioning

confidence: 99%

“…Although one of the five patients developed delayed bleeding, endoscopic hemostasis was safely performed. Other case series of RIC for colorectal anastomosis and NKSt also report performance of these techniques safely and with low complication rates (delayed bleeding: 0 % to 3.3 %, perforation: 0 % to 0.4 %) [7][8][9][10]. Second, the indication for RIC is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…The RIC procedure was performed based on the method reported in previous studies [6][7][8][9] (▶ Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

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Endoscopic radial incision and cutting for Crohn’s Disease-associated intestinal stricture: a pilot study

et al. 2020

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Background and study aims Intestinal stricture associated with Crohn’s disease (CD) is usually treated by endoscopic balloon dilation (EBD) or stricture plasty. Although EBD is effective and safe for such strictures, refractory stricture after EBD poses a problem. Hence, other novel approaches for these refractory strictures are required. On the other hand, the efficacy of radial incision and cutting (RIC) method for esophageal stricture after esophagogastric surgery is reported. In this pilot study, we adopted the RIC technique for five CD patients with refractory intestinal stricture to dilate their strictures. We conducted the RIC procedure using an electric needle knife with a ceramic tip on the top of the needle. Four cases were of anastomotic stricture after ileocecal resection and the remaining one case was of stricture due to mucosal healing. The RIC procedure was successful for all five patients. Average procedure time was 18.6 minutes. One patient developed delayed bleeding after RIC. There were no cases of perforation. RIC could be an alternative therapy for intestinal stricture associated with CD. Further studies should be conducted to clarify its efficacy and safety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endoscopic radial incision and cutting for Crohn’s Disease-associated intestinal stricture: a pilot study

et al. 2020

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“…However, repeated EBD sessions have been reported to be required to relieve the symptoms of dysphagia in some patients . Incisional therapy has been introduced as a new method for patients with anastomotic stricture . In RIC, directly slicing off fibrotic tissues is the key to maintain a wide and stable lumen.…”

Section: Discussionmentioning

confidence: 99%

“…21 Incisional therapy has been introduced as a new method for patients with anastomotic stricture. 22,23 In RIC, directly slicing off fibrotic tissues is the key to maintain a wide and stable lumen. The RIC treatment is considered a safe and effective choice for anastomotic stricture.…”

Section: Discussionmentioning

confidence: 99%

Circular incision and cutting, a novel treatment for patients with esophageal cancer with anastomotic stricture after esophagectomy

Jie

Tang

et al. 2018

J of Digest Diseases

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Objective Endoscopic balloon dilation (EBD) is still considered the standard treatment for patients with anastomotic strictures after esophagectomy. However, repeated dilation sessions are often required to maintain the lumen patency. We therefore developed a novel method called circular incision and cutting (CIC) and compared the efficacy of CIC and EBD among patients with anastomotic strictures after esophagectomy or gastrectomy. Methods In this retrospective study, 71 consecutive patients with esophageal cancer with anastomotic strictures after esophagectomy or gastrectomy between January 2011 and December 2016 were included. Among them, 22 patients received CIC therapy and 49 were treated with EBD. Results The dysphagia in all patients immediately ameliorated and no serious adverse events requiring further intervention were observed after CIC therapy. Compared with EBD, CIC exhibited a greater score in the difference of dysphagia before and after treatment (1.73 vs 1.16, P = 0.03). Moreover, the interval of restenosis and 6‐month lumen patency in CIC had a better effect than that in EBD (88.07 days vs 62.76 days, P = 0.001; dysphagia score 0.63 vs 1.44, P = 0.007). Conclusion The CIC method may be an effective and safe option for patients with esophageal cancer with anastomotic strictures after esophagectomy.

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Balloon enteroscopy-assisted radial incision and cutting method for refractory hepaticojejunostomy anastomotic strictures

et al. 2019

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Background Balloon enteroscopy-assisted balloon dilation and temporary biliary stent placement are effective for hepaticojejunostomy anastomotic strictures (HJAS), but the re-stenosis rates are relatively high. We examined the feasibility and efficacy of a novel treatment technique for refractory HJAS, called balloon enteroscopy-assisted radial incision and cutting (BE-RIC). Methods Between January 2016 and June 2018, 11 patients with refractory HJAS that recurred after balloon dilation and/or stent placement, underwent BE-RIC. We evaluated the technical success, clinical success, adverse events, and re-stenosis rates associated with BE-RIC. Results The technical success rate of BE-RIC was 91 % (10/11). Clinical success was achieved in all patients who underwent technically successful procedures. The procedure-related adverse event rate was 9 % (1/11). No re-stenosis was observed during the follow-up period; 9 patients were followed up for more than 6 months, and of these, 5, 4, and 2 patients were followed up for more than 12, 18, and 24 months, respectively, without re-stenosis. Conclusions BE-RIC for refractory HJAS showed favorable results. BE-RIC might be a useful option for treating refractory HJAS.

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

Cited by 9 publications

References 5 publications

Endoscopic radial incision and cutting for Crohn’s Disease-associated intestinal stricture: a pilot study

Endoscopic radial incision and cutting for Crohn’s Disease-associated intestinal stricture: a pilot study

Circular incision and cutting, a novel treatment for patients with esophageal cancer with anastomotic stricture after esophagectomy

Balloon enteroscopy-assisted radial incision and cutting method for refractory hepaticojejunostomy anastomotic strictures

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