NON-OPERATIVE MANAGEMENT OF BENIGN COLORECTAL ANASTOMOTIC STENOSIS IN PATIENTS UNDERGOING ELECTIVE SURGERY FOR NON-METASTATIC PRIMARY RECTAL CANCER


Mercan U., Ersen O., Yuksel C., Yalkin O., AKBULUT S., Unal E., ...Daha Fazla

JOURNAL OF MEDICAL AND SURGICAL RESEARCH, cilt.7, sa.1, ss.792-797, 2020 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 7 Sayı: 1
  • Basım Tarihi: 2020
  • Dergi Adı: JOURNAL OF MEDICAL AND SURGICAL RESEARCH
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Directory of Open Access Journals
  • Sayfa Sayıları: ss.792-797
  • Anahtar Kelimeler: Endoscopy, Rectal Neoplasms, Stenosis, LOW ANTERIOR RESECTION, BALLOON DILATION, STRICTURES
  • Ankara Üniversitesi Adresli: Evet

Özet

Introduction: Benign anastomosis stenosis may develop in postoperative or long term period due to many reasons such as anastomosis leakage and anastomosis ischemia after colorectal surgery. In this study, we aimed to present our clinical experience in the treatment of benign anastomosis strictures in patients undergoing elective surgery for nonmetastatic primary rectal cancer. Material and Methods: One hundred fifty-six (156) patients who underwent resection and colorectal anastomosis between January 2013 and January 2018 were included in the study: 22 patients developed benign anastomotic stenosis has been determined and etiological factors and treatment modalities applied has been compared retrospectively. Results: In 22 patients, 9 patients were treated with digital or balloon dilatation, at least 2 sessions and up to 5 sessions. Four patients were treated with dilatation followed by stenting. The remaining 9 patients were taken to surgical treatment. Among whole patients with stenosis, it has been determined that 15 of them had neoadjuvant therapy history, 5 had anastomosis leakage and in 16 of them 28 mm circular stapler have been used. Discussion and Conclusion: Neoadjuvant treatment history, the presence of anastomosis leakage and the usage of 28 mm circular stapler have been detected to be the most important etiological factors in development of benign anastomotic stenosis. Endoscopic treatments should be tried primarily to treat benign anastomotic stenosis. High success rates can be achieved with endoscopic methods and patient quality of life can be improved. With this approach, the need for surgery will be reduced and possible postoperative complications can be prevented.