Endoscopic treatment of benign gastrointestinal anastomotic strictures using argon plasma coagulation in combination with diathermy.
BACKGROUND
Initially, treatment for anastomotic strictures was surgical. Currently. however, endoscopic techniques are preferred. This study aimed to investigate the efficiency and safety of endoscopic treatment using argon plasma coagulation in combination with diathermy.


METHODS
From 1995 to 2000, 49 patients with postsurgical anastomotic strictures of the esophagus or colon were referred for endoscopic treatment. In all cases, radiologic and endoscopic examination showed membranous or short strictures (diameter, 3-8 mm). Under direct endoscopic control, the scar tissue at the anastomotic line was incised radially with a polypectomy snare. The scar tissue between the incisions then was reduced carefully by argon plasma coagulation.


RESULTS
All 49 patients were treated successfully with this combined endoscopic technique. Only for four patients was more than one endoscopic session (mean, 3.5; range, 2-6) needed to guarantee long-term success. No complications were encountered.


CONCLUSIONS
Endoscopic argon plasma coagulation in combination with diathermy is a safe and effective technique for the treatment of short postsurgical gastrointestinal anastomotic strictures.
Schubert
D
D
Department of General, Visceral and Vascular Surgery, Faculty of Medicine, Otto von Guericke University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany. schubertdan72@hotmail.com
Kuhn
R
R
Lippert
H
H
Pross
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004564:Electrocoagulation / Q000379:methods*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence