CURRENT STATUS OF ENDOSCOPIC TREATMENT FOR BENIGN STENOSIS OF THE LOWER GASTROINTESTINAL TRACT(WITH A VIDEO)

Abstract

The causes of acquired gastrointestinal stenosis vary, including advanced cancer, scars after healing of inflammation, scars after endoscopic treatment, and surgical anastomosis. However, the treatment of gastrointestinal stenosis is targeted only when it causes a passage obstruction. In the case of upper gastrointestinal tract stenosis, treatment is performed to allow foods to pass; in the case of lower gastrointestinal tract stenosis, treatment is performed to allow the passage of stool. In cases of advanced cancers that require resection, surgery aimed at relieving the stenosis and a radical cure may be the first choice. However, surgery aimed solely at relieving the stenosis is the last resort in many cases. Especially for benign stenosis, mechanical dilation has long been the first choice of treatment and the method to avoid surgery. In this paper, we describe the current status of endoscopic dilation for the lower gastrointestinal tract stenosis with bougie, balloon dilation, and radial incision and cutting (RIC). As compared to the past, one of the advances is that treatment is often performed using an endoscope to confirm how the stenosis is dilated. However, there has been no breakthrough in discussing the methodology of mechanical dilation. I would also like to describe the current problems and prospects.