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Colorectal anastomotic stenosis results of a survey of the ASCRS membership

 

作者: Martin Luchtefeld,   Jeffrey Milsom,   Anthony Senagore,   James Surrell,   W. Mazier,  

 

期刊: Diseases of the Colon & Rectum  (OVID Available online 1989)
卷期: Volume 32, issue 9  

页码: 733-736

 

ISSN:0012-3706

 

年代: 1989

 

出版商: OVID

 

关键词: Anastomotic stenosis;Colorectal surgery;Treatment of stenosis

 

数据来源: OVID

 

摘要:

&NA;Anastomotic stenosis is a poorly understood and underexamined complication of gastrointestinal surgery, reportedly most frequent in the coloproctostomy. In order to better define this problem, a questionnaire was sent to members of the American Society of Colon and Rectal Surgeons regarding patients with gastrointestinal anastomotic stenosis. A total of 123 patients with intestinal anastomotic stenosis were analyzed. Eighty‐two anastomoses were stapled and 41 were handsewn. Nearly all stenoses occurred in the distal bowel (70 rectal, 23 sigmoid colon). Preoperative risk factors identified were obesity (28 patients) and abscess (12 patients). Incomplete “doughnuts” were noted in 12 patients. Postoperative anastomotic leaks (15 patients), pelvic infection (13 patients), and postoperative radiation (7 patients) were believed to be contributing factors. Dilatation, using a variety of techniques, was the sole treatment for 65 patients, however, intra‐abdominal surgery was necessary in 34 patients. Large intestinal anastomotic stenosis probably occurs most commonly following coloproctostomy (both with handsewn and stapled anastomoses). Dilatation alone resulted in adequate treatment in most patients in the study. Major surgery was required to correct this problem in a significant number of patients (28 percent) in this series. The true incidence of anastomotic stenosis in colorectal surgery is unknown and warrants further study.

 

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