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Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures
Benign anastomotic strictures can occur in up to 22% of patients who undergo colonic or rectal resection. Traditionally, surgery was the preferred method of treatment, but, over time, endoscopic techniques, such as balloon dilation, have become the preferred modality. However, a high stricture recur...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hellenic Society of Gastroenterology
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566767/ https://www.ncbi.nlm.nih.gov/pubmed/28845102 http://dx.doi.org/10.20524/aog.2017.0163 |
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author | Jain, Deepanshu Sandhu, Naemat Singhal, Shashideep |
author_facet | Jain, Deepanshu Sandhu, Naemat Singhal, Shashideep |
author_sort | Jain, Deepanshu |
collection | PubMed |
description | Benign anastomotic strictures can occur in up to 22% of patients who undergo colonic or rectal resection. Traditionally, surgery was the preferred method of treatment, but, over time, endoscopic techniques, such as balloon dilation, have become the preferred modality. However, a high stricture recurrence rate of up to 18-20% and the increased risk of perforation due to uncontrolled stretching are its major drawbacks. Endoscopic electrocautery incision (EECI) allows for controlled mucosal incision in predetermined locations of stricture. In this meta-analysis, we have summarized case reports, case series, retrospective studies and prospective studies describing the different endoscopic EECI techniques used for benign lower gastrointestinal tract anastomotic strictures. Our analysis showed that EECI, either alone or in combination with other modalities (e.g. balloon dilation, steroid injection or argon plasma coagulation) is an effective treatment option for both treatment-naïve and refractory short non-inflammatory strictures. The overall success rate for EECI-based therapy for benign colorectal stricture was 98.4%, with a stricture recurrence rate of 6.0%. No major adverse event (bleeding, infection or perforation) was reported. Only minor adverse events (abdominal pain) were reported in 3.8% of the population. |
format | Online Article Text |
id | pubmed-5566767 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Hellenic Society of Gastroenterology |
record_format | MEDLINE/PubMed |
spelling | pubmed-55667672017-08-25 Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures Jain, Deepanshu Sandhu, Naemat Singhal, Shashideep Ann Gastroenterol Review Article Benign anastomotic strictures can occur in up to 22% of patients who undergo colonic or rectal resection. Traditionally, surgery was the preferred method of treatment, but, over time, endoscopic techniques, such as balloon dilation, have become the preferred modality. However, a high stricture recurrence rate of up to 18-20% and the increased risk of perforation due to uncontrolled stretching are its major drawbacks. Endoscopic electrocautery incision (EECI) allows for controlled mucosal incision in predetermined locations of stricture. In this meta-analysis, we have summarized case reports, case series, retrospective studies and prospective studies describing the different endoscopic EECI techniques used for benign lower gastrointestinal tract anastomotic strictures. Our analysis showed that EECI, either alone or in combination with other modalities (e.g. balloon dilation, steroid injection or argon plasma coagulation) is an effective treatment option for both treatment-naïve and refractory short non-inflammatory strictures. The overall success rate for EECI-based therapy for benign colorectal stricture was 98.4%, with a stricture recurrence rate of 6.0%. No major adverse event (bleeding, infection or perforation) was reported. Only minor adverse events (abdominal pain) were reported in 3.8% of the population. Hellenic Society of Gastroenterology 2017 2017-05-30 /pmc/articles/PMC5566767/ /pubmed/28845102 http://dx.doi.org/10.20524/aog.2017.0163 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Jain, Deepanshu Sandhu, Naemat Singhal, Shashideep Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
title | Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
title_full | Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
title_fullStr | Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
title_full_unstemmed | Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
title_short | Endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
title_sort | endoscopic electrocautery incision therapy for benign lower gastrointestinal tract anastomotic strictures |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566767/ https://www.ncbi.nlm.nih.gov/pubmed/28845102 http://dx.doi.org/10.20524/aog.2017.0163 |
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