Safe and Effective Treatment of Colorectal Anastomotic Stricture Using a Well-defined Balloon Dilation Protocol

Purpose: To present a well-defined protocol for balloon dilation for colorectal anastomotic strictures and evaluate clinical efficacy of the dilation in 42 patients. Materials and Methods: From October 1999 to June 2010, 42 patients (32 males and 10 females with mean age 52.1 years +/- 16.3) with surgical colorectal anastomotic strictures who received transanal balloon dilation using a well-defined protocol were retrospectively investigated. After the procedure, a water-soluble contrast media study was performed to detect possible complications. Stricture diameter was measured 1 month after balloon dilation. Clinical outcomes and recurrence were evaluated with a median follow-up period of 63.7 months. Results: There were 47 dilation sessions performed in 42 patients. Technical success and clinical success were achieved in all patients. At long-term follow-up, 36 (85.7%) patients had complete improvement. No complications were observed in any patients. Stricture diameter 1 month after the procedure was 8.85 cm +/- 3.23, which was a significant increase over stricture diameter before the procedure of 5.89 cm +/- 2.64 (P < .001), showing increase in diameter by 50.3%. Four (9.5%) patients experienced symptomatic recurrence. Stricture diameter of the patients with recurrence was considerably larger than stricture diameter of other patients (P = .036). Conclusions: Fluoroscopically guided balloon dilation using the protocol described is safe and clinically effective for treatment of colorectal anastomotic stricture.