title: Evaluation of efficacy of endoscopic incision method in postoperative benign anastomotic strictures of gastrointestinal system.
abstract: BACKGROUND
  Postoperative benign anastomotic strictures (POBAS) which develop after surgical resections of the gastrointestinal system (GIS) present with symptoms depending on location of the stricture. Diagnosis is confirmed by endoscopic and radiological methods. Although bougie or balloon dilatation is preferred in management, the endoscopic incision method (EIM) is also used with considerable success. In this trial, we aimed to evaluate EIM, which is one of the endoscopic dilatation techniques used in postoperative anastomotic stricture of GIS.
  
  
  METHODS
  A total of 20 POBAS patients, 12 men and 8 women, subjected to EIM intervention for strictures, were enrolled in the trial. The number of patients with upper GIS strictures was 6 (30%), while the number of cases with lower GIS strictures was 14 (70%).
  
  
  RESULTS
  Dilatation of the stricture was achieved in 15 (75%) patients with one treatment session, while more than one session of EIM was needed in 5 (25%) cases. Mean duration of follow-up of patients was 10.65 ±5.86 (0-25) months. Procedure-related complications developed in 8 patients. Among them, 7 were minor complications and improved without any treatment. In only 1 (5%) patient, perforation was observed as a major complication. Following EIM, recurrence of POBAS was observed in 5 (25%) patients. The following parameters were found to have an impact on successful outcome in EIM: presence or absence of a tortuous lumen in POBAS (p = 0.035) and length of stricture (p = 0.02), complications during the procedure (if any), and presence of single or multiple strictures.
  
  
  CONCLUSIONS
  Endoscopic incision method may be regarded as a favorable approach among first choice treatment alternatives in uncomplicated anastomotic strictures of GIS, or it may be used as an adjunctive dilatation method.
authors.affiliation: Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Avcioglu
authors.affiliation: Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Şehmus
authors.initials: Ş
authors.lastname: Ölmez
authors.affiliation: Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Tuğrul
authors.initials: T
authors.lastname: Pürnak
authors.affiliation: Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Ersan
authors.initials: E
authors.lastname: Özaslan
authors.affiliation: Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Altıparmak
keywords: anastomosis; endoscopic incision; stricture