Abstract
The authors report their experience of 30 patients with colorectal anastomotic stenosis treated by 62 dilatation sessions in order to evaluate which anastomotic characteristics could influence the success of dilatation therapy. Patients were subdivided into group A (dilatation successful) and group B (dilatation unsuccessful). Overall, dilatation was successful in 73.3% of cases, with only one important complication. The prognostic factors considered were anastomotic dehiscence, adjuvant radiotherapy, presence of colostomy at dilatation, site, morphology and length of the stenosis, presence of neoplastic recurrence, type of anastomosis and type of dilatation. Radiotherapy, local neoplastic recurrence and large anastomotic dehiscence were the more important independent prognostic factors. If present together, they were associated with an almost 100% probability of failure and, vice versa, if they were absent this probability was 5%.
Résumé
Les auteurs rapportent l'expérience sur 30 patients porteurs de sténose anastomotique colo-rectale traités par 62 séances de dilatation et tentent de préciser quelles sont les caractéristiques anastomotiques qui peuvent influencer sur le succès de la dilatation. Les patients ont été divisés en deux groupes: le groupe A chez lequel la dilatation a été réalisée avec succès et le groupe B chez lequel la dilatation a été infructueuse. Dans l'ensemble, la dilatation a été efficace chez 73,3% des cas avec seulement une complication importante. Les facteurs pronostiques considérés furent la déhiscence anastomotique, la radiothérapie adjuvante, la présence d'une colostomie lors de la dilatation, l'emplacement, la morphologie, la longuer de la sténose, la présence d'une récidive tumorale, le type d'anastomose et le type de dilatation. La radiothérapie, la récidive néoplasique locale et une large déhiscence anastomotique constituent les facteurs pronostiques et indépendants les plus importants. Si ces facteurs sont présents ensemble, ils sont associés avec une probabilité d'échec de la dilatation de près de 100% alors que s'ils sont absents les trois, la probabilité d'échec n'est que de 5%.
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Pucciarelli, S., Toppan, P., Pilati, P.L. et al. Efficacy of dilatations for anastomotic colorectal stenoses: prognostic factors. Int J Colorect Dis 9, 149–152 (1994). https://doi.org/10.1007/BF00290192
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DOI: https://doi.org/10.1007/BF00290192