Abstract
Background and Study Aims: Endoscopic dilation has proven to be a valid therapeutic alternative to surgery for
treating postoperative anastomotic colonic strictures. The authors here evaluate retrospectively
the short and long-term clinical results obtained in such patients by pneumatic dilation.
Patients and Methods: From March 1986 to December 1993, 18 patients who had undergone surgery for colorectal
cancer were treated for a postoperative symptomatic stricture. Four patients had undergone
a left hemicolectomy and 14 an anterior resection. The strictures had a diameter of
less than 2 mm, and a length ranging from 5 to 29 mm. The dilations were performed
using a 30-40 mm pneumatic dilator for achalasia. The clinical results were classified
in relation to the abdominal symptomatology reported by the patients, and were evaluated
in the short term (one week) and long term (mean follow-up: 39 months).
Results: Seventeen of the 18 patients underwent a total of 45 dilating sessions; one patient
was excluded because a recurrence was diagnosed at the suture line. Five patients
had a single dilating session; eight patients had two sessions, and four patients
had a mean of 4.5 sessions. Two complications were observed: a punctiform bowel perforation
and one transient mucosal bleeding. Immediate symptomatic relief was achieved in all
cases, and good long-term clinical results were achieved in 16 patients (94.1 %).
Conclusions: Endoscopic dilation with an achalasia balloon has proved to be safe and simple to
perform, and allowed us to obtain good short-term and long-term clinical results.
This type of dilation may be considered the first-line therapeutic approach for symptomatic
benign colonic anastomotic strictures.
