Treatment strategies of the colorectal anastomosis stricture

Czech version

Authors: P. Zbořil ¹; P. Skalický ¹; L. Starý ¹; I. Klementa ¹; L. Bébarová ¹; M. Konečný ²; P. Janda ¹; K. Vysloužil ¹
Authors‘ workplace: I. chirurgická klinika LF UP a FN Olomouc, přednosta: doc. MUDr. Č. Neoral, CSc. ¹; II. interní klinika FN a LF UP Olomouc, přednosta: Doc. MUDr. V. Procházka, Ph. D. ²
Published in: Rozhl. Chir., 2013, roč. 92, č. 10, s. 559-562.
Category: Original articles

Overview

Introduction:
The treatment of the stenoses of colorectal anastomoses represents a difficult area of colonic surgery. This is partly connected to the introduction of staplers and an increasing amount of sphincter-preserving surgeries. At our clinic, we solve the stenoses of colorectal anastomoses using a surgical rectoscope with a good effect.

Material and methods:
We analysed retrospectively a group of 27 patients with benign stenosis of colorectal anastomosis of the medial and upper rectum who underwent surgery at our clinic in the period between January 2004 and December 2011. From the total amount of 27 patients, in 23 patients the stenosis was caused by the dehiscence of anastomosis, and in 4 patients the stenosis had a different etiology.

Results:
In the group of 27 patients, in 14 patients the stenosis of colorectal anatomosis was solved radiologically using a high pressure balloon. Total of 13 patients underwent surgery, in 10 of them we used the surgical rectoscope and 3 patients underwent an open abdominal procedure.

Conclusion:
The first method of choice in treatment of the stenoses of the colorectal anastomoses is a balloon dilatation. If this is not successful we can use the surgical rectoscope as a minimally invasive though effective and safe method.

Key words:
stenosis of colorectal anastomosis – surgical rectoscope – balloon dilatation

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