Comparison of the Efficacy of Endoscopic Radial Incision and Cutting Procedure and Endoscopic Balloon Dilation for Benign Anastomotic Stricture After Low Anterior Resection Combined With Preventive Loop Ileostomy in Rectal Cancer

BACKGROUND: Endoscopic radical incision and cutting procedure is a notable technique in the treatment of benign anastomotic strictures after low anterior resection in rectal cancer. However, the efficacy and safety of endoscopic radical incision and cutting procedure and traditional endoscopic balloon dilatation remain unknown. OBJECTIVE: To compare the efficacy and safety of endoscopic radical incision and cutting procedure and endoscopic balloon dilatation in patients with anastomotic stricture after low anterior resection. DESIGN: Rectal cancer patients with anastomotic stricture after low anterior resection combined with synchronous preventive loop ileostomy between January 2014 and June 2021 were retrospectively collected. These patients underwent endoscopic radical incision and cutting procedure or endoscopic balloon dilatation as an initial treatment. The clinicopathological baseline data of the patients, endoscopic surgery success rate, complications and restricture rate were analyzed. SETTINGS: This study was conducted at Nanfang Hospital in China. PATIENTS: A total of 30 patients were eligible after reviewing the medical records. Twenty patients underwent endoscopic balloon dilatation and ten patients underwent endoscopic radical incision and cutting procedure. MAIN OUTCOME MEASURES: The adverse event rate and stricture recurrence rate. RESULTS: There were no significant differences in patient demographics or clinical features. No adverse events occurred in either of the two groups. The mean operation time was 18.9±3.6 minutes in the endoscopic balloon dilatation group and 10.2±3.3 minutes in the endoscopic radical incision and cutting procedure group ( p < 0.001). The stricture recurrence rates between the endoscopic balloon dilatation group and the endoscopic radical incision and cutting procedure group were significantly different (44.4% vs. 0%, p = 0.025). LIMITATIONS: This was a retrospective study. CONCLUSIONS: The endoscopic radical incision and cutting procedure is a safe procedure and is more efficacious than endoscopic balloon dilatation for anastomotic stricture after low anterior resection combined with synchronous preventive loop ileostomy in rectal cancer.