title: Endoscopic electrocautery dilation of benign anastomotic colonic strictures: a single-center experience.
abstract: BACKGROUND
  Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures.
  
  
  METHODS
  Sixty patients (37 women; median age 63.6 years, range 22.6-81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up.
  
  
  RESULTS
  The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3-60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0-144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation.
  
  
  CONCLUSIONS
  Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy. ivana.bravi@ieo.it.
authors.forename: Ivana
authors.initials: I
authors.lastname: Bravi
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Ravizza
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Giancarla
authors.initials: G
authors.lastname: Fiori
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Darina
authors.initials: D
authors.lastname: Tamayo
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Trovato
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Roberto
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Genco
authors.affiliation: Division of Endoscopy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Crosta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D003106:Colon / Q000601:surgery*; D003113:Colonoscopy; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D004106:Dilatation; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Anastomotic strictures; Colon; Electrocautery dilation
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