Endoscopic hook knife cutting before balloon dilatation of a severe anastomotic stricture after rectal cancer resection

Abstract

Anastomotic stricture associated with suture failure develops in 5 % – 10 % of patients after resection of rectal cancer [1]. Direct digital dilatation or transrectal surgical treatment is possible if the anastomosis is located in the lower rectum. Endoscopic balloon dilatation is the best method for all the remaining patients in whom these procedures for the lower rectum cannot be done [2]. However, double stapling of the rectal anastomosis may induce intractable and severe re-stenosis, so a procedure that includes endoscopic incision with a papillotomy knife has been reported [3] [4].