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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(02): E231-E236
DOI: 10.1055/a-2230-7372
Original article

Insulated tip/needle-knife endoscopic stricturotomy is safe and effective for treatment of non-traversable anorectal strictures

Koby Herman
1   Colorectal Surgery, Columbia University Irving Medical Center, New York, United States (Ringgold ID: RIN21611)
,
Ravi P. Kiran
1   Colorectal Surgery, Columbia University Irving Medical Center, New York, United States (Ringgold ID: RIN21611)
,
Bo Shen
2   Center for Inflammatory Bowel Disease, Columbia University Irving Medical Center, New York, United States (Ringgold ID: RIN21611)
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Correction: Insulated tip/needle-knife endoscopic stricturotomy is safe and effective for treatment of non-traversable anorectal stricturesEndosc Int Open 2024; 12(02): 3-3
DOI: 10.1055/a-2272-9459

Abstract

Background and study aims The treatment of anorectal strictures is particularly challenging and historically focused on surgical resection and/or diversion. There are a number of endoscopic options, but repeat interventions are common. The use of the needle knife stricturotomy technique as an alternative to surgery in the treatment of a variety of strictures has been described, but its use for the treatment of severe anorectal and anopouch strictures has not been studied.

Patients and methods Our Inflammatory Bowel Disease department’s records were queried to identify patients with endoscopic non-traversable anorectal/anopouch strictures. Consecutive patients that underwent insulated tip/needle-knife endoscopic stricturotomy treatment were included. Primary outcome was immediate traversability of the treated stricture by the endoscope. Other outcomes included need for reintervention, 30-day post-procedure events, and follow-up period events.

Results All strictures were immediately successfully traversed following endoscopic stricturotomy treatment. The mean time to endoscopic reintervention was 5.3 months, with the majority of these patients undergoing repeat stricturotomy. Over a mean follow-up period of 12.8 months, two patients (8%) required surgical intervention (resection with coloanal anastomosis with a colostomy and complete proctectomy) for refractory stricture disease following initial endoscopic stricturotomy. Seven patients (29%) in our study have not required any further reintervention throughout the study period. There were no 30-day post-procedure adverse events and no adverse post-procedure events.

Conclusions Endoscopic stricturotomy is safe and effective in treating severe anorectal/anopouch strictures.

Keywords

Endoscopy Lower GI Tract - Inflammatory bowel disease - Endoscopy Small Bowel


Publication History

Received: 22 January 2023

Accepted after revision: 24 October 2023

Article published online:
15 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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