Colorectal anastomotic stenosis after elective laparoscopic sigmoidectomy for diverticular disease: a prospective evaluation of 68 patients
| Autor: | Jean-Louis Frossard, Patrick Ambrosetti, Reymond De Peyer, Karim Mohamed Francis |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Colon Sigmoid/surgery Colon Diverticulitis Colonic/surgery Colonoscopy Constriction Pathologic digestive system Diverticulitis Colonic Colon Sigmoid medicine Colon/pathology Humans Rectum/pathology Prospective Studies Prospective cohort study Laparoscopy health care economics and organizations Aged ddc:616 Aged 80 and over medicine.diagnostic_test business.industry General surgery Anastomosis Surgical digestive oral and skin physiology Rectum Gastroenterology Anastomosis Surgical/adverse effects General Medicine Diverticulitis Middle Aged medicine.disease Dilatation digestive system diseases Colorectal surgery Surgery Endoscopy Stenosis surgical procedures operative Constriction Pathologic/etiology/therapy Diverticular disease Female business |
| Zdroj: | Diseases of the colon and rectum, Vol. 51, No 9 (2008) pp. 1345-9 |
| ISSN: | 1530-0358 |
| Popis: | PURPOSE: This prospective study was designed to find the incidence of symptomatic anastomotic stenosis after elective laparoscopic sigmoidectomy for diverticular disease. METHODS: Sixty-eight patients who underwent elective laparoscopic sigmoidectomy with double-stapling colorectal anastomosis between November 1998 and June 2007 were included. Follow-up after hospitalization was performed by using sequential rectoscopy for all patients. Symptomatic patients with anastomotic stricture were treated. RESULTS: No patient died postoperatively and no patient had anastomotic leak or abdominal septic complication. Twenty-two patients (32 percent) had postoperative symptoms that suggested anastomotic stenosis; 12 of them (17.6 percent) eventually needed dilatation of their anastomosis (median diameter of the stenosis: 7 mm) a mean time of 176 days postoperatively. Eight patients had only one session, three patients had two sessions, and one patient had three sessions. There were no complications and all patients were symptom-free after dilatation. Age, sex, obesity, hypertension, diabetes, and vascular preservation had no influence on the risk of anastomotic stenosis. CONCLUSIONS: Incidence of symptomatic anastomotic stenosis after elective laparoscopic sigmoidectomy is high (17.6 percent). No risk factor could be identified. Endoscopic dilatations were successful without complication in all cases. Regular rigid rectoscopy definitely should be part of the postoperative follow-up in symptomatic patients. |
| Databáze: | OpenAIRE |
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