Endoscopy 2012; 44(03): 297-300
DOI: 10.1055/s-0031-1291482
Case report/series
© Georg Thieme Verlag KG Stuttgart · New York

Usefulness of biodegradable polydioxanone stents in the treatment of postsurgical colorectal strictures and fistulas

F. Pérez Roldán
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
P. González Carro
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
M. C. Villafáñez García
2   Department of Emergency, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
S. Aoufi Rabih
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
M. L. Legaz Huidobro
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
N. Sánchez-Manjavacas Múñoz
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
O. Roncero García-Escribano
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
M. Ynfante Ferrús
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
E. Bernardos Martín
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
,
F. Ruiz Carrillo
1   Department of Gastroenterology, Hospital General La Mancha-Centro, Alcázar de San Juan, Spain
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Publikationsverlauf

submitted 04. Juli 2011

accepted after revision 28. September 2011

Publikationsdatum:
19. Januar 2012 (online)

Benign colonic strictures and fistulas are a growing problem presenting most commonly after bowel resection. Standard treatment is with endoscopic bougies or, more usually, balloon dilation. When these approaches are not successful, other solutions are available and different endoscopic and surgical approaches have been used to treat fistulas. We present an additional option – biodegradable stents – for the treatment of colonic strictures and fistulas that have proven refractory to other endoscopic interventions. We analyzed the results from 10 patients with either a postsurgical colorectal stricture (n = 7) or rectocutaneous fistula (n = 3) treated with the biodegradable SX-ELLA esophageal stent (covered or uncovered). Stents were successfully placed in nine patients, although early migration subsequently occurred in one. Placement was impossible in one patient due to deformity of the area and the fact that the stricture was approximately 30 cm from the anus. The fistulas were successfully closed in all patients, although symptoms reappeared in one patient. In the six patients who received stents for strictures, symptoms resolved in five; in the remaining patient, the stent migrated shortly after the endoscopy. Treatment of colonic strictures and rectocutaneous fistulas with biodegradable stents is an effective alternative in the short-to-medium term. The stent does not have to be removed and is subject to very few complications. The drawbacks of this approach are the need to repeat the procedure in some patients and the lack of published series on efficacy.

 
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