Endoscopic electrocautery dilation of benign anastomotic colonic strictures

a single-center experience

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures. Methods: Sixty patients (37 women; median age 63.6 years, range 22.6–81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up. Results: The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3–60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0–144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation. Conclusions: Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.

Original languageEnglish
Pages (from-to)229-232
Number of pages4
JournalSurgical Endoscopy and Other Interventional Techniques
Volume30
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

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Electrocoagulation
Dilatation
Pathologic Constriction
Colonoscopes
Safety
Recurrence
Colorectal Surgery
Symptom Assessment

Keywords

  • Anastomotic strictures
  • Colon
  • Electrocautery dilation

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Endoscopic electrocautery dilation of benign anastomotic colonic strictures: a single-center experience",
abstract = "Background: Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures. Methods: Sixty patients (37 women; median age 63.6 years, range 22.6–81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up. Results: The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3–60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0–144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation. Conclusions: Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.",
keywords = "Anastomotic strictures, Colon, Electrocautery dilation",
author = "Bravi, {Ivana Maria} and Davide Ravizza and Giancarla Fiori and Darina Tamayo and Cristina Trovato and {De Roberto}, Giuseppe and Chiara Genco and Cristiano Crosta",
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T1 - Endoscopic electrocautery dilation of benign anastomotic colonic strictures

T2 - a single-center experience

AU - Bravi, Ivana Maria

AU - Ravizza, Davide

AU - Fiori, Giancarla

AU - Tamayo, Darina

AU - Trovato, Cristina

AU - De Roberto, Giuseppe

AU - Genco, Chiara

AU - Crosta, Cristiano

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures. Methods: Sixty patients (37 women; median age 63.6 years, range 22.6–81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up. Results: The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3–60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0–144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation. Conclusions: Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.

AB - Background: Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures. Methods: Sixty patients (37 women; median age 63.6 years, range 22.6–81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up. Results: The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3–60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0–144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation. Conclusions: Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.

KW - Anastomotic strictures

KW - Colon

KW - Electrocautery dilation

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DO - 10.1007/s00464-015-4191-0

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