Methods:

We performed a retrospective, longitudinal study which includes data obtained from a database of patients in endoscopic surveillance of colorectal cancer who underwent surgery and anastomosis between January 2014 and January 2019. Clinical outcomes and risk factors for anastomotic stricture were investigated.

Results:

Among 213 patients included, 39 (18.3%) were diagnosed having anastomotic stricture. The analysis revealed that intersphincteric resection (odds ratio [OR] = 18.81; confidence interval 95% (CI 3.31 - 189.40, p<0.001) and diverting stoma OR = 7.07 95% (CI 3.10 - 16.57, p<0.001) were independent risk factors of anastomotic stricture. Anastomostic stapler use was found as a protective factor against stricture OR = 0.41 (CI 0.16 - 1.1, p=0.04). Twenty seven patients (69.2%) were treated by endoscopic procedures, 51% underwent baloon dilation, 22.2% incisional therapy, 18.5% were dilated with the scope and 7.4% underwent both baloon dilation and incisional therapy. Average sessions needed was 1.57 (minimum 1 y maximum 4), 83.3% resolved and 2.6% presented stricture recurrence. No complications were reported after endoscopic treatment. In conclusion, patients treated with intersphincteric resection and the presence of a diverting stoma are risk factors for anastomotic stricture after surgery. Anastomotic stapler use was found as a protective factor against stricture development. Therapeutic endoscopic options for colorectal anastomotic strictures are effective and safe, but clinicians should carefully select a conservative dilation method because actually there is no consensus about the gold standard treatment method.

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