Colorectal anastomotic strictures: treatment by fluoroscopic double balloon dilation.
OBJECTIVE
To evaluate the therapeutic efficacy and complications of fluoroscopically guided double balloon dilation for treatment of colorectal anastomotic strictures.


METHODS
Under fluoroscopic guidance, 17 patients with colorectal anastomotic strictures underwent transanal double balloon dilation. Thirteen of 17 strictures were the consequence of surgery for malignant disease and the other four were secondary to surgery for benign disease. Sixteen of 17 patients had difficult or frequent defecation caused by partial obstruction. In the remaining one asymptomatic patient, the stricture was detected by endoscopy and barium enema after total proctocolectomy and a temporary ileostomy for ulcerative colitis. The therapeutic efficacy and complications were evaluated during the follow-up.


RESULTS
Seventeen patients underwent double balloon dilation in a single session. The diameter of the first balloon was 20 mm and the second balloon's diameter was 10, 15, or 20 mm. Technical success was achieved in all 17 patients. After balloon dilation, complete (n = 12, 71%) or incomplete (n = 5, 29%) improvement of symptoms was achieved in all patients. Major complications such as perforation or severe hemorrhage did not occur. During the mean follow-up period of 23 months (range, 1-62 months), one patient (6%) developed a recurrent stricture and required a second session of double balloon dilation 6 months after initial balloon dilation.


CONCLUSIONS
Fluoroscopically guided double balloon dilation is an effective and safe method for the treatment of colorectal anastomotic strictures.
Di
Zhen-Hai
ZH
Department of Interventional Radiology, Affiliated Hospital of Jiangsu University.
Shin
Ji Hoon
JH
Kim
Jin Hyoung
JH
Song
Ho-Young
HY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D002404:Catheterization / Q000379:methods*; D003108:Colonic Diseases / Q000601:surgery; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome