Colorectal anastomotic stenosis results of a survey of the ASCRS membership

Martin A. Luchtefeld, Jeffrey W. Milsom, Anthony Senagore, James A. Surrell, W. Patrick Mazier

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    161 Scopus citations


    Anastomotic stenosis is a poorly understood and underexamined complication of gastrointestinal surgery, reportedly most frequent in the coloproctostomy. In order to better define this problem, a questionnaire was sent to members of the American Society of Colon and Rectal Surgeons regarding patients with gastrointestinal anastomotic stenosis. A total of 123 patients with intestinal anastomotic stenosis were analyzed. Eighty-two anastomoses were stapled and 41 were handsewn. Nearly all stenoses occurred in the distal bowel (70 rectal, 23 sigmoid colon). Preoperative risk factors identified were obesity (28 patients) and abscess (12 patients). Incomplete “doughnuts” were noted in 12 patients. Postoperative anastomotic leaks (15 patients), pelvic infection (13 patients), and postoperative radiation (7 patients) were believed to be contributing factors. Dilatation, using a variety of techniques, was the sole treatment for 65 patients, however, intra-abdominal surgery was necessary in 34 patients. Large intestinal anastomotic stenosis probably occurs most commonly following coloproctostomy (both with handsewn and stapled anastomoses). Dilatation alone resulted in adequate treatment in most patients in the study. Major surgery was required to correct this problem in a significant number of patients (28 percent) in this series. The true incidence of anastomotic stenosis in colorectal surgery is unknown and warrants further study.

    Original languageEnglish (US)
    Pages (from-to)733-736
    Number of pages4
    JournalDiseases of the Colon & Rectum
    Issue number9
    StatePublished - Sep 1989


    • Anastomotic stenosis
    • Colorectal surgery
    • Treatment of stenosis

    ASJC Scopus subject areas

    • Gastroenterology


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