Causes analysis and Treatment of Benign Anastomotic Stenosis after Radical Resection for Rectal Cancer
XU Jing,WANG Juan,ZHAO Yong-jie
Department of General Surgery, Tianjin Union Medical Center, Tianjin (300121), China
Abstract:
Objective To analyze the causes and treatment of benign anastomotic stenosis after radical resection for rectal cancer. Methods The clinical data of 75 patients with anastomotic stenosis from 2013 to 2018 at Tianjin Union Medical Center were retrospectively analyzed. The patients underwent artificial expansion, endoscopic balloon dilatation, fully covered self-expandable metallic stent and surgical treatment. Results The main causes of the benign anastomotic stenosis were inflammatory hyperplasia (52.0%), anastomotic leakage (9.3%), scar formation (37.3%), and radiation enterocolitis (1.3%). Twenty-three cases (<5 cm from the dentate line) accepted the artificial expansion of the anastomosis through the anus. Of 48 cases (5–15cm from the dentate line) of anastomotic stenosis, 29 cases were treated with endoscopic balloon dilatation and 19 cases underwent fully covered self-expandable metallic stent placement under colonoscopy. One case was treated by anus radialincision of the stenosis ring. Two patients (the length of stenosis<1 cm and >10 cm from the dentate line) underwent anastomosis following the anastomotic stenosis resection. One patient with low and severe stenosis was given permanent descending colon single-chamber stoma. All cases were followed up for 12 months, and the stenosis was relieved. Conclusion Benign anastomotic stenosis is the result of inflammatory hyperplasia, anastomotic leakage, scar formation, and radiation enterocolitis, which should be prevented in advance. The different procedures are chosen to relieve obstruction in terms of the causes, degree and location of stenosis.
