Safe and effective treatment of colorectal anastomotic stricture using a well-defined balloon dilation protocol

J Vasc Interv Radiol. 2012 May;23(5):675-80. doi: 10.1016/j.jvir.2011.12.014. Epub 2012 Feb 22.

Abstract

Purpose: To present a well-defined protocol for balloon dilation for colorectal anastomotic strictures and evaluate clinical efficacy of the dilation in 42 patients.

Materials and methods: From October 1999 to June 2010, 42 patients (32 males and 10 females with mean age 52.1 years ± 16.3) with surgical colorectal anastomotic strictures who received transanal balloon dilation using a well-defined protocol were retrospectively investigated. After the procedure, a water-soluble contrast media study was performed to detect possible complications. Stricture diameter was measured 1 month after balloon dilation. Clinical outcomes and recurrence were evaluated with a median follow-up period of 63.7 months.

Results: There were 47 dilation sessions performed in 42 patients. Technical success and clinical success were achieved in all patients. At long-term follow-up, 36 (85.7%) patients had complete improvement. No complications were observed in any patients. Stricture diameter 1 month after the procedure was 8.85 cm ± 3.23, which was a significant increase over stricture diameter before the procedure of 5.89 cm ± 2.64 (P < .001), showing increase in diameter by 50.3%. Four (9.5%) patients experienced symptomatic recurrence. Stricture diameter of the patients with recurrence was considerably larger than stricture diameter of other patients (P = .036).

Conclusions: Fluoroscopically guided balloon dilation using the protocol described is safe and clinically effective for treatment of colorectal anastomotic stricture.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Catheterization / adverse effects
  • Catheterization / methods*
  • Colon / surgery*
  • Constriction, Pathologic
  • Contrast Media
  • Digestive System Surgical Procedures / adverse effects*
  • Female
  • Fluoroscopy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Radiography, Interventional / methods
  • Rectum / surgery*
  • Recurrence
  • Republic of Korea
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Contrast Media