Endoscopic Approach to Benign Anastomotic Stricture in the Upper Gastrointestinal Tract
Ogün Erşen *
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
Ümit Mercan
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
Cemil Yüksel
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
Serkan Akbulut
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
Ali Ekrem Ünal
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
Sancar Bayar
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
Salim Demirci
Ankara University Medicine Faculty, General Surgery Department, Clinic of Surgical Oncology, Turkey.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Benign anastomosis strictures are frequently seen in anastomoses performed after upper gastrointestinal system resections. Although the first step in treatment is the preferred endoscopic procedures, surgical treatment is also an option. Mortality and morbidity of surgical treatment is at a very high rate compared to endoscopic approaches.
Materials Methods: 523 surgical operations, which underwent UGI resection and anastomosis between 31 December 2014 and 31 December 2019 at the surgical oncology clinic, were retrospectively scanned from the hospital database. All patients were those who had surgery for malignancy.
Results: The median age of the patients was 55 ± 12 (32-78) and 55% (n = 10) patients were male and 44% (n = 8) patients were female. When the patients were evaluated in terms of their current symptoms at the time of admission, the most common symptom was reported as dysphagia with 83% (n = 15) of the patients. 66% (n = 12) nausea was present.
Discussion: Indication should be selected by considering the indications in stent and balloon dilatation in anastomosis strictures. Balloon dilation can be considered as the main procedure. Stricturotomy, cauterization are also among the options of treatment. Endoscopic treatment can be done safely in qualified hands
Keywords: Anastomosis, stricture, malignancy, endoscopy.