Endoscopic treatment of postoperative colorectal anastomotic strictures

Surg Endosc. 2003 Jul;17(7):1110-3. doi: 10.1007/s00464-002-8926-3. Epub 2003 May 6.


Background: The postoperative development of benign colorectal anastomotic stricture remains a frequent and unsolved problem.

Methods: From 1996 until 2002, we analyzed 94 consecutive patients with postoperative colorectal anastomotic stenosis who were treated endoscopically.

Results: Sixty-eight patients were initially resected for malignant disease, and 26 patients for benign conditions. Most frequently, hydrostatic balloon dilatation was performed; in selected cases, it was combined with a laser or argon plasma coagulation (APC) incision, or a laser incision only. Dilatation was successful in 59% of patients resected for cancer and 88% resected for a benign condition. Complications developed in 17 patients (benign restenosis, perforation, abscess); they were significantly more frequent after initial cancer resection than after resection for a benign condition ( p < 0.05).

Conclusion: High success and low complication rates make endoscopic dilatation the treatment of choice to avoid high-risk reoperations in patients with benign anastomotic stricture. The presence of stapler anastomosis, postoperative leakage, and/or radiotherapy does not significantly impede successful endoscopic dilatation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / adverse effects
  • Colon / surgery*
  • Colonoscopy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / surgery*
  • Rectum / surgery*