Effect comparison between endoscopic incision and balloon dilation for refractory anastomotic benign stricture after colorectal surgery
10.3760/cma.j.issn.1673-4904.2019.05.013
- VernacularTitle:内镜下切开术和球囊扩张术治疗结直肠术后难治性吻合口良性狭窄的疗效比较
- Author:
Yan WANG
1
;
Feng SU
;
Yuanyuan LI
;
Shu LI
Author Information
1. 济宁医学院附属湖西医院消化内科
- Keywords:
Surgical stomas;
Constriction,pathologic;
Endoscopes;
Balloon dilation;
Comparative effectiveness research
- From:
Chinese Journal of Postgraduates of Medicine
2019;42(5):429-432
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy between endoscopic incision (EI) and endoscopic balloon dilation (EBD) for refractory anastomotic benign stricture after colorectal surgery. Methods The clinical data of 72 patients with refractory anastomotic benign stricture after colorectal surgery from June 2011 to June 2016 in Huxi Hospital Affiliated to Jining Medical College were retrospectively analyzed. In the patients, 34 cases were treated with EI (EI group), and 38 cases were treated with EBD (EBD group). The postoperative endoscopic patency rate, symptom relief rate, time of treatment, relapse rate, anastomotic diameter at the last follow- up and complication between 2 groups were compared. Results The patients in 2 groups completed the operation successfully, the anastomotic stricture was relieved and the obstruction symptom disappeared 1 month after operation. There were no statistical differences in endoscopic patency rate and symptom relief rate 6 months after operation between 2 groups (P＞0.05). The endoscopic patency rate and symptom relief rate 12 and 24 months after operation in EI group were significantly higher than those in EBD group, endoscopic patency rate: 88.2% (30/34) vs. 42.1% (16/38) and 64.7% (22/34) vs. 31.6% (12/38), symptom relief rate: 76.5% (26/34) vs. 42.1% (16/38) and 61.8% (21/34) vs. 28.9% (11/38), and there were statistical differences (P＜0.05 or＜0.01). The time of treatment and relapse rate in EI group were significantly lower than those in EBD group:(1.6 ± 0.3) times vs. (2.6 ± 0.8) times and 5.9% (2/34) vs. 73.7% (28/38), the anastomotic diameter at the last follow-up was significantly larger EBD group: (1.87 ± 0.23) cm vs. (1.09 ± 0.18) cm, and there were statistical differences (P＜0.05 or ＜0.01). There was no statistical difference in incidence of complication between 2 groups (P＞0.05). Conclusions The mid- and long-term efficacy of EI in the treatment of refractory anastomotic benign stricture after colorectal surgery is significantly better than that of EBD, and the recurrence rate is low.
