{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:39:43Z","timestamp":1784173183524,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T00:00:00Z","timestamp":1486080000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the results of treatment for colorectal (<jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content>), coloanal (<jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content>) or ileal pouch\u2013anal (<jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content>) anastomotic stenosis (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>All patients operated on for <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> from 1995 to 2014 were included. Success was defined as the absence of an additional surgical procedure for <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> during 12\u00a0months after the last procedure and the absence of a stoma at the end of follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty consecutive patients presenting with <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> after <jats:styled-content style=\"fixed-case\">CRA<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>16, 32%), <jats:styled-content style=\"fixed-case\">CAA<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>18, 36%) or <jats:styled-content style=\"fixed-case\">IPAA<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>16, 32%), performed for colorectal cancer (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>28, 56%), familial adenomatous polyposis (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>5, 10%), inflammatory bowel disease (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>8, 16%), diverticulitis (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>4, 8%), benign colorectal neoplasia (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>3, 6%) or other (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>2, 4%) underwent a total of 99 procedures including digital (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>14, 14%), instrumental (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>38, 38%) or endoscopic dilatation (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>5, 5%), transanal <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> stricturoplasty (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>9, 10%), transanal circular stapler resection (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>11, 11%) or transabdominal redo\u2010anastomosis (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>22, 22%). Overall the per\u2010procedure success rate was 53% (52\/99). Success rates were 36% (5\/14) for digital dilatation, 40% (15\/38) for instrumental dilatation, 20% (1\/5) for endoscopic dilatation, 64% (7\/11) for circular stapler resection, 89% (8\/9) for stricturoplasty and 73% (16\/22) for transabdominal redo\u2010anastomosis. After a mean follow\u2010up of 46\u00a0months, 42\/50 (84%) patients had treatment that was considered successful. Multivariate analysis identified redo\u2010anastomosis [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a05.1 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.4\u201318.7), <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003] as the only independent prognostic factor for success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> should be managed according to a step\u2010up strategy. Conservative procedures are associated with acceptable success rates. If these fail, transabdominal redo\u2010anastomosis is associated with the highest probability of success.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13587","type":"journal-article","created":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T13:12:42Z","timestamp":1482239562000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":65,"title":["Anastomotic stenosis after coloanal, colorectal and ileoanal anastomosis: what is the best management?"],"prefix":"10.1111","volume":"19","author":[{"given":"A.","family":"Kraenzler","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris and University Paris VII Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Maggiori","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris and University Paris VII Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Pittet","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Beaujon Hospital Assistance Publique\u2010H\u00f4pitaux de Paris and University Paris VII Clichy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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