LONG-TERM RESULTS AFTER ENDOSCOPIC DILATION OF POST-OPERATIVE COLO-COLONIC ANASTOMOTIC STENOSES. OUR EXPERIENCE IN 42 PATIENTS.

The aim of this study is to evaluate long-term complications and patient's quality of life after the endoscopic treatment of benign anastomotic colo-colonic strictures. From January 2000 to November 2008,, 42 patients who had undergone surgery for colorectal cancer were endoscopically treated for a postoperative symptomatic stricture. The dilation were performed using a 20-30 mm pneumatic dilator. The clinical results were classified in relation to the abdominal symptomatology reported by the patients, and were evaluated in the short-term (one-week) and long-term (mean follow-up.36 months)period. Results: 15 patients underwent a total of 22 dilating sessions; 9 patients had a single dilating session, 18 patients underwent 5 dilating sessions. Three bowel peforations at the site of dilation, 1 septic complications and a transient mucosal bleeding were registered. immediate symptomatic relief was achieved in all the cases; the symptoms caused by the strictures disappeared after the first session. Normal defecation was immediately restored after the treatment. satisfactory good long-term clinical results were achieved in thirty-seven patients (88%). Conclusion: This study confirms the assumption that dilation with balloon may be considered the first-line therapeutic approach safe and effective for symptomatic benign anastomotic strictures after colorectal resection surgery for adenocarcinoma. The treatment of benign anastomotic strictures by standard endoscopic dilation is an effective contribution against stricture-related gastrointestinal symptoms. The standard criterion used to define successful anastomoses (10-13 mm in diameter)is sufficient for an optimal result.