ArticleSurgical endoscopy2018
Anastomotic stricture after ultralow anterior resection or intersphincteric resection for very low-lying rectal cancer.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06036862 (A Prospective Clinical Study of Transanal and Transabdominal Combined Endoscopic Resection of Rectal Stenosis and Anal Reconstruction for Severe Rectal Anastomotic Stenosis), which is not on this map. Cited by 33 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Clinical Study of Transanal and Transabdominal Combined Endoscopic Resection of Rectal Stenosis and Anal Reconstruction for Severe Rectal Anastomotic Stenosis
Who cites it
33 citing papers in PubMed, 79 citations in OpenAlex.
- Effectiveness of intraoperative stay sutures and postoperative anal dilatation in preventing anastomotic stricture after low rectal cancer resection with defunctioning stoma.BMC gastroenterology · 2026Trial
- The Treatment Efficacy for Patients Undergoing Combined Transanal-Transabdominal Endoscopic Resection of Rectal Anastomosis Stenosis.Journal of surgical oncology · 2026Article
- Article
- Patient-Reported Outcomes and Surgical Results of Hand-Sewn Versus Stapled Anastomosis for Lower Rectal Cancer Located 4-5 cm From the Anal Verge: A Subanalysis of the Ultimate Study.Annals of gastroenterological surgery · 2025Article
- Late anastomotic complication after laparoscopic surgery for clinical stage I low rectal cancers located within 5 cm of the anal verge: Sub-analysis of the ultimate trial.Annals of gastroenterological surgery · 2025Article
- Development and validation of a predictive model for anastomotic complications with mid-low rectal cancer based on propensity score matching analysis-Does robotic surgery have an advantage?Journal of robotic surgery · 2025Article
- Efficacy of reinforcing sutures in preventing anastomotic leakage after surgery for rectal cancer: A systematic review and metaanalysis.World journal of gastrointestinal surgery · 2025Article
- Comparison of side-to-side anastomosis vs. end-to-end anastomosis in NOSES operation for left colon cancer: a retrospective study.BMC surgery · 2025Article
- Analysis of treatment methods and relapse factors of postoperative anastomotic stenosis in colorectal cancer.Surgical endoscopy · 2025Article
- Balloon dilatation followed by triamcinolone acetonide injection for colostomy stenosis: A case report.International journal of surgery case reports · 2024Article
- A nomogram of anastomotic stricture after rectal cancer: a retrospective cohort analysis.Surgical endoscopy · 2024Article
- Novel magnetic compression technique for the treatment of postoperative anastomotic stenosis in rectal cancer: A case report.World journal of gastrointestinal surgery · 2024Article
- Treatment of anastomotic stricture after rectal cancer operation by magnetic compression technique: A case report.World journal of gastrointestinal surgery · 2024Article
- Risk factors for the failure of endoscopic balloon dilation to manage anastomotic stricture from colorectal surgery: retrospective cohort study.Surgical endoscopy · 2024Article
- Resolution of occult anastomotic stricture with anal dilator: challenges with the conventional diagnostic criteria in low anterior rectal resection patient-a case report.Frontiers in oncology · 2024Article
- Defunctioning stoma and anastomotic stricture in rectal cancer surgery: a propensity score matching study.Langenbeck's archives of surgery · 2023Article
- Risk factors affecting benign anastomotic stricture in anterior and low anterior resections for colorectal cancer: a single-center retrospective cohort study.Surgical endoscopy · 2023Article
- Single center experience with salvage surgery for chronic pelvic sepsis.Updates in surgery · 2022Article
- Efficacy of staple line reinforcement by barbed suture for preventing anastomotic leakage in laparoscopic rectal cancer surgery.World journal of gastrointestinal surgery · 2022Article
- Nomogram to predict permanent stoma in rectal cancer patients after sphincter-saving surgery.World journal of gastrointestinal surgery · 2022Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR).
methodsWe retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge. Clinical outcomes and risk factors for anastomotic stricture were investigated.
resultsAmong the 586 patients included, 46 (7.8%) were diagnosed as having anastomotic stricture. Multivariable logistic regression analysis revealed that intersphincteric resection (ISR) with hand-sewn anastomosis (odds ratio [OR] = 3.070; 95% confidence interval [CI] 1.247-7.557) and postoperative radiotherapy (OR 6.237; 95% CI 1.961-19.841) were independent risk factors of anastomotic stricture. Forty-one (89.1%) underwent anastomotic dilatation with a Hegar dilator; while three patients (6.5%) underwent endoscopic balloon dilatation and two (4.3%) underwent surgery initially. Among the patients with initial nonoperative management (n = 44), 21 (47.7%) were completely cured with nonoperative management alone, 12 (27.3%) experienced complications, such as bowel perforation, anastomotic rupture, and perirectal abscess; and 21 (47.7%) underwent further surgical management. Fifteen patients (32.6%) eventually had permanent stoma.
conclusionISR with a hand-sewn coloanal anastomosis, compared to ULAR with double-stapling anastomosis, and postoperative radiotherapy were independent risk factors of anastomotic stricture after surgery for very low-lying rectal cancer. Nonoperative anastomotic dilatation showed poor clinical outcome, with high complication rates, and subsequent surgical management. Therefore, nonoperative management of such patients should be carefully selected.
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