Endoscopic radial incision and cutting technique for treatment-naive stricture of colorectal anastomosis: Two case reports

Table 1 Patient demographic and clinical characteristics prior to the radial incision and cutting procedure

Case	1	2
Age (yr)/Gender	78/Female	47/Female
Chief complaints before surgery	Hematochezia, constipation, tenesmus	Abdominal pain, constipation
Clinical symptoms at diagnosis	None	Abdominal distension, constipation
Comorbidity	HTN	Insomnia, mood disorder
Past history of abdominal surgery	None	TLH with BSO
Operation method	LAR	HAR
Temporary ileostomy	Yes	No
Postoperative complication	None	None
Pathology	Adenocarcinoma	Endometriosis
Stage	pT3N0M0
Adjuvant therapy	None	None

HTN: Hypertension; TLH: Total laparoscopic hysterectomy; BSO: Bilateral salphongo-oophorectomy; LAR: Low anterior resection; HAR: High anterior resection.

Table 2 Clinical outcomes of the radial incision and cutting procedure and colonoscopic findings

Patient	1	2
Duration from surgery to endoscopic RIC (mo)	3	4
Sedative drugs	Midazolam	Midazolam, propofol
Distance between AS and anal verge (cm)	4	12
Diameter of AS (mm)	2	4
Ileostomy status at time of endoscopic RIC	Yes	No
Pretreatment before RIC	None	None
Procedure time (min)	12	20
Major complications	None	None
Post-procedural hospital stays (d)	3	2
Follow-up after endoscopic RIC (mo)	20	23

AS: Anastomotic stenosis; RIC: Radial incision and cutting.

Table 3 Previous report of only using endoscopic radical incision and cutting for anastomotic stenosis (review of the literature)

	Kawaguti et al[12]	Harada et al[14]	Osera et al[11]	Asayama et al[13]	Our study
Number of the patient, n	1	3	7	3	2
Median age (yr), (range)	67	62 (NA)	66 (56-72)	72 (65-76)	62.5 (47-78)
Gender (male:female)	NA	3:0	6:1	3:0	0:2
Median interval from surgery to RIC (mo), (range)	NA	7 (5-12)	11 (5-44)	21 (9-29)	3.5 (3-4)
AS location	R	R	R	T, S, S	R
Temporary stoma at time of RIC, n	1	1	3	NA	1
Treatment naive AS, n	1	0	0	2	2
Previous treatment of RIC, n	None	3	7	1	None
Bougie dilatation		NA	5	0
Endoscopic balloon dilatation		NA	2	1
Endoscopic RIC with single session, n	1	2	4	2	2
Mean number of RIC sessions	1	1.3	2.3	2.7	1
Median procedure time (min), (range)	12	69.5 (35-82)	18 (7-34)	22 (15-25)	16 (12-20)
Major complication	None	None	None	None	None
Median post-procedural hospital stay (d), (range)	NA	3.5 (3-4)	3 (2-5)	4 (2-5)	2.5 (2-3)
Median follow-up after RIC (mo), (range)	8	17 (3-33)	27 (18-55)	25 (5-34)	21.5 (20-23)
Treatment after restenosis, n	0	1	2	1	0
Treatment failure, n	0	0	2	0	0

RIC: Radial incision and cutting; AS: Anastomotic stenosis; NA: Not available; R: Rectum; T: Transverse colon; S: Sigmoid colon.