Endoscopic treatment of stenosis following stapler anastomosis

Accordi, Franco; Sogno, Osvaldo; Carniato, Stefano; Fabris, G.; Moschino, P; Coan, Buno; Carlon, C. A.

doi:10.1007/bf02554819

Cited by 16 publications

(9 citation statements)

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“…Electrocautery is frequently combined with dilation using hydrostatic balloons to maximize release of the rectal stricture. 25,26,[28][29][30][31]34,35,38 In four of seven of the series using electrocautery/laser, further treatment was required, 25,26,34,35 with a recurrence rate of up to 13.9 percent. 36 It allows for high rectal lesions up to 18 cm to be removed.…”

Section: Strictureplasty With Electrocautery or Lasermentioning

confidence: 99%

Management of Benign Rectal Strictures

Garcea¹,

Sutton²,

Lloyd³

et al. 2003

Diseases of the Colon &Amp; Rectum

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Section: Strictureplasty With Electrocautery or Lasermentioning

confidence: 99%

Management of Benign Rectal Strictures

Garcea¹,

Sutton²,

Lloyd³

et al. 2003

Diseases of the Colon &Amp; Rectum

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“…These methods are not always useful for the treatment of tubular strictures because of the presence of thick, long scars, although they are effective for membranous strictures [4,7]. Endoscopic electrocautery incisions are able to split the hard, thick scar.…”

Section: Discussionmentioning

confidence: 99%

Sigmoidofiberscopic Incision plus Balloon Dilatation for Anastomotic Cicatricial Stricture after Anterior Resection of the Rectum

et al. 1999

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We describe the procedure and examine the therapeutic efficacy of a combination of sigmoidofiberscopic incision plus balloon dilatation for tubular stricture by thick, long scar tissue at the colorectal anastomosis after anterior resection for rectal cancer. Balloon dilatation alone does not always relieve the strictures, although this method is the usual therapy for this condition. Five patients were identified in whom the stricture was not improved with balloon dilatation alone. Of these five patients, three complained of difficulty defecating, a feeling of incomplete evacuation, residual feces, and lower abdominal fullness. The remaining two patients, who had transverse colostomy to treat major leakage at the anastomosis, showed no symptoms. All five patients underwent the combination therapy described below. Two or three small radial incisions were made in the scar of the stricture with electrocautery under fiberscopic vision. Then the strictural scar was split and loosened bluntly along the incisions over a 15- to 20-minute period with a balloon dilator. This procedure was performed once or twice at a 2-week interval. In all five patients the stricture was improved according to objective criteria. There was also an improvement in the subjective symptoms suffered by three patients. The improvements were maintained over observation periods of 9 to 15 months. No complications were observed. Sigmoidofiberscopic incision plus balloon dilatation is an effective, safe therapy for cicatricial strictures after anterior resection for rectal cancer when the strictures have failed to improve following balloon dilatation alone.

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“…The other advantages of incisional technique over distending techniques are: (1) widening of the stricture under vision, (2) no force or minimal forces are applied to the stricture, (3) the entire instrument need not be introduced through the stricture, (4) widening of the stenosis is immediate, and (5) the entire procedure can be repeated safely. This technique had been reported in 13 patients [1,3,9,10]. The incision was made with the ERCP papillotome, snare, and urethrotome knife.…”

Section: Incisional Dilatation Of a Stenosed Stapled Coloproctostomymentioning

confidence: 99%