title: Safe and effective treatment of colorectal anastomotic stricture using a well-defined balloon dilation protocol.
abstract: OBJECTIVE
  To present a well-defined protocol for balloon dilation for colorectal anastomotic strictures and evaluate clinical efficacy of the dilation in 42 patients.
  
  
  METHODS
  From October 1999 to June 2010, 42 patients (32 males and 10 females with mean age 52.1 years ± 16.3) with surgical colorectal anastomotic strictures who received transanal balloon dilation using a well-defined protocol were retrospectively investigated. After the procedure, a water-soluble contrast media study was performed to detect possible complications. Stricture diameter was measured 1 month after balloon dilation. Clinical outcomes and recurrence were evaluated with a median follow-up period of 63.7 months.
  
  
  RESULTS
  There were 47 dilation sessions performed in 42 patients. Technical success and clinical success were achieved in all patients. At long-term follow-up, 36 (85.7%) patients had complete improvement. No complications were observed in any patients. Stricture diameter 1 month after the procedure was 8.85 cm ± 3.23, which was a significant increase over stricture diameter before the procedure of 5.89 cm ± 2.64 (P < .001), showing increase in diameter by 50.3%. Four (9.5%) patients experienced symptomatic recurrence. Stricture diameter of the patients with recurrence was considerably larger than stricture diameter of other patients (P = .036).
  
  
  CONCLUSIONS
  Fluoroscopically guided balloon dilation using the protocol described is safe and clinically effective for treatment of colorectal anastomotic stricture.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap 2dong, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Pyeong Hwa
authors.initials: PH
authors.lastname: Kim
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Jung-Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Han Kyu
authors.initials: HK
authors.lastname: Na
authors.forename: Ye Jin
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000601:surgery*; D003251:Constriction, Pathologic; D003287:Contrast Media; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D015641:Radiography, Interventional / Q000379:methods; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003287:Contrast Media