title: Management of recurrent anastomotic stricture and iatrogenic stenosis by circular stapler.
abstract: Anastomotic stricture is an increasingly common clinical finding. It is thought to arise because of ischemia, disruption, or leakage at an anastomosis site. Its management can be difficult and strictures often are resistant to standard dilation therapy. Major corrective surgery is possible; however, it is technically challenging and not without risk. We have used a circular stapler to excise colorectal strictures, introducing the anvil of the stapler via a proximal stoma or colotomy, drawing the anvil through the stricture with a snare via a colonoscope and affixing it to the body of a circular staple gun and excising the stricture. We have with found this to be an effective treatment in appropriately selected patients.
authors.affiliation: Department of Colorectal Surgery, North Bristol NHS Trust, Bristol, United Kingdom. jrer@hutchinson-mrc.cam.ac.uk
authors.forename: J R E
authors.initials: JR
authors.lastname: Rees
authors.forename: L
authors.initials: L
authors.lastname: Carney
authors.forename: T S
authors.initials: TS
authors.lastname: Gill
authors.forename: A R
authors.initials: AR
authors.lastname: Dixon
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods*; D003251:Constriction, Pathologic / Q000139:chemically induced / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007410:Intestinal Diseases / Q000139:chemically induced / Q000209:etiology / Q000601:surgery*; D008297:Male; D019800:Phenol / Q000009:adverse effects; D012008:Recurrence; D012597:Sclerosing Solutions / Q000009:adverse effects; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D012597:Sclerosing Solutions; D019800:Phenol