A New Device for the Treatment of Coloproctostomic Stricture after Double Stapling Anastomoses
- 1 November 1996
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 224 (5), 603-608
- https://doi.org/10.1097/00000658-199611000-00004
Abstract
A new device of staple cutter was developed to evaluate the clinical effect for the treatment of rectal stricture after the double stapling anastomosis. The double stapling technique has become an established reconstruction method for patients with low anterior resection. The major complication of anastomotic stricture associated with circular stapling has been reported to be harmful and distressing. Because underlying mechanisms of stricture are not well understood, no prophylactic means have been developed and this results in postoperative dilation still being the only treatment available. Although various dilation methods are used for the treatment of stricture, none is fully satisfactory. Low anterior resection was performed in 30 patients with rectal carcinoma using a double stapling technique. First, the incidence of the anastomotic stricture and the clinical factors that contribute to the stricture formation were studied. Second, the clinical effects and advantages of the treatment of coloproctostomic stricture using the newly developed device (staple cutter) were evaluated. Nine (30%) of 30 patients had anastomotic stricture with the symptom of distressing frequent bowel movement. There was no significant relation between the clinical factors and the stricture when compared with that of nonstricture patients. Excellent dilation was performed in all of the nine strictures using the staple cutter, and the symptom of stricture disappeared dramatically in eight patients (89%) within 1 week. The recurrence of stricture occurred in two patients; however, it has not been observed after one further use of this treatment. The staple cutter is safe and easy to use even at the bedside, and except for a conventional anoscope, no special equipment, including fluoroscope, was needed. From the significant effects and advantages, the procedure using staple cutter is recommended highly for the treatment of circular stapling anastomotic stricture of the rectum.Keywords
This publication has 25 references indexed in Scilit:
- Hydrostatic balloon dilation of gastrointestinal stenoses: a national surveyGastrointestinal Endoscopy, 1986
- Experience with Stapling in Rectal SurgerySurgical Clinics of North America, 1984
- Endoscopic incision of postoperative stenoses in the upper gastrointestinal tractGastrointestinal Endoscopy, 1983
- A comparison of end-to-end staple and suture colorectal anastomosis in the dog.1981
- Anastomosis with EEA stapler after anterior colonic resectionDiseases of the Colon & Rectum, 1981
- Complications of anterior resection of the rectum using the EEA stapling deviceBritish Journal of Surgery, 1981
- An improved technique for low anterior resection of the rectum using the EEA stapler.1980
- A Stapling Instrument for End-to-end Inverting Anastomoses in the Gastrointestinal TractAnnals of Surgery, 1979
- Endoscopic Treatment of Stenosized Anastomosis after GastrectomyEndoscopy, 1977
- Use of a Mechanical Suturing Apparatus in Low Colorectal AnastomosisArchives of Surgery, 1975