Endoscopic radial incision in the treatment of benign atresia and stenosis of colorectal anastomosis
ZHONG Dunjing1, SONG Jian2, LI Ping3, CHEN Zhaowei3, ZHANG Ronglin3, REN Yanjun4
1. Department of Gastroenterology, the University of Hong Kong-Shenzhen Hospital, Shenzhen 518000,China; 2. Department of Gastroenterology,South University of Science and Technology Hospital, Shenzhen 518055,China; 3. Department of Gastroenterology,Hainan Cancer Hospital, Shenzhen 570100,China; 4. The Third Medical Centre, General Hospital of PLA,Beijing 100039,China
Abstract：Objective To investigate the effect of endoscopic radial incision in the treatment of benign colorectal anastomotic stenosis. Methods Twenty-five patients with benign anastomotic stenosis and atresia after colorectal surgery were selected from January 2018 to December 2020. All patients were treated with endoscopic radial incision for benign colorectal anastomotic stenosis . The operation was performed by same doctors with same method. The effect, intraoperative and postoperative complications about endoscopic radial incision and the recurrence rate of anastomotic stenosis were observed. The patients were followed up to evaluate the obstruction symptoms and recurrence of anastomotic stenosis. Results Twenty-five patients(100.0%) were treated successfully. The operation time was 14-42 minutes and the average time was 18.7 minutes; the hospital stay was 3-7 days and the average time was 4 days. The preoperative diameter of anastomotic astium was 0-10 mm, the average of diameter was (6.67±2.48) mm; the postoperative diameter of ones was 14-18 mm, the average of diameter was (16.17±1.27)mm; the postoperative diameter of ones at six months after surgery was 13-15 mm, the average of diameter was (15.29±1.04) mm. There was statistically significant difference of diameter between preoperation and postoperation (P<0.05). Conclusions Endoscopic radial incision is a safe and effective method in the treatment of benign anastomotic stenosis after colorectal surgery.
Dowden J E,Stanley J D,Moore R A.Obstructed defecation after stapled hemorrhoidopexy:a report of four cases[J]. Am Surg,2010,76(6):622-625.
[5]
Lan N,Shen B.Endoscopic stricturotomy with needle knife in the treatment of strictures from inflammatory bowel disease[J]. Inflamm Bowel Dis,2017,23(4):502-513.
[6]
Koch M R,Jagannathan J P,Shinagare A B,et al.Imaging features of primary anorectal gastrointestinal stromal tumors with clinical and pathologic correlation[J]. Cancer Imaging, 2013, 12(3): 557-565.
[7]
Acar T,Aslan F,Acar N,et al.Role of endoscopic interventions and electroincision in benign anastomotic strictures following colorectal surgery[J].Turk J Gastroenterol,2019,30(8):673-679.
[8]
Bertocchi E, Barugola G, Benini M, et al. Colorectal anastomotic stenosis: lessons learned after 1643 colorectal resections for deep infiltrating endometriosis[J].Minim Invasive Gynecol,2019,26(1):100-104.
Yuan X, Liu W, Ye L, et al. Combination of endoscopic incision and balloon dilation for treatment of a completely obstructed anastomotic stenosis following colorectal resection:a case report[J].Medicine(Baltimore),2019,98(26):6292.
[13]
Belverdere B,Frattaroli S,Crabone A,et al. Anastomotic strictures in colorectal surgery: treatment with endoscopic balloon dilation[J].G Chir, 2012, 33(6-7):243-245.
[14]
Biraima Magdalena,Adamina Michel,Jost Res,et al. Long-term results of endoscopic balloon dilation for treatment of colorectal anastomotic stenosis.[J]. Surg Endosc,2016,30(10):116-118.
Chen Hong-Lin.A completely occluded colorectal anastomotic stenosis treated using an endoscopic incision method.[J]. Am J Gastro, 2018,113(2):174.
[18]
Asayama N, Nagata S, Shigita K, et al. Effectiveness and safety of endoscopic radial incision and cutting for severe benign anastomotic stenosis after surgery for colorectal carcinoma: a three-case series[J].Endosc Int Open,2018,6(3):E335-E339.
2022, Vol. 33 
