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Clin Colon Rectal Surg
DOI: 10.1055/s-0045-1807728
Review Article

Surgery-induced and Associated Long-term Strictures

Matthew J. Freeman
1   Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
2   Clinical Science Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
,
Corinne E. Praska
1   Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
2   Clinical Science Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
,
Cristina B. Sanger
1   Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
2   Clinical Science Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
3   Department of Surgery, William S. Middleton Memorial Veteran's Hospital, Madison, Wisconsin
› Author Affiliations
Funding M.J.F. was supported by T32 Funding from the University of Wisconsin Madison Medical Scientist Training Program from the National Institute of General Medical Sciences (T32 GM140935 and T32 GM008692) and the University of Wisconsin Microbes in Health and Disease from the National Institute of Allergy and Infectious Diseases (T32 AI055397). C.E.P. was supported by T32 funding from the University of Wisconsin Surgical Oncology Research Training Program (NIH, NIC T32CA090217). The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or UW Hospitals and Clinics. The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the views of the U.S. Department of Veterans Affairs or the United States Government.
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Abstract

Strictures, commonly referred to as stenoses, are a rare but significant complication for patients who have undergone colorectal surgery. Strictures are difficult to diagnose due to variable clinical presentations, diverse etiologies, and lack of formalized diagnostic criteria. The clinical impact of strictures can be quite variable, ranging from a benign course not requiring intervention to emergent complications (e.g., bowel obstruction, perforation). Importantly, strictures can also have a large impact on patient quality of life and long-term bowel function. Once a stricture is diagnosed or clinically suspected, it is critical to determine its etiology to help guide clinical management and prevent recurrence. Strictures can be categorized as partial or complete, intrinsic or extrinsic, benign or malignant. We propose the ARCTIC mnemonic (Anastomosis, Radiation/Chemotherapy, Technical, Inflammation, and Compression) as a useful tool for remembering common stricture causes in the postoperative environment. This review seeks to provide an overview of the etiologies, diagnosis, and management of strictures in the postoperative setting.

Keywords

stricture - anastomosis - obstruction - complication - stenosis


Publication History

Article published online:
17 April 2025

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