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21 patients with a severe anastomotic stenosis in the colorectal region were treated with hydraulic balloon dilatation and endoscopic electroincision. The severity of symptoms directly correlates with the extent of stenosis (degree I Ø 13 mm, n = 12; degree II Ø 7 mm, n = 6; degree III Ø 4 mm, n = 3). All patients with a stenosis of degree I and II were symptom-free after the endoscopic therapy. In 2 of 3 cases the symptoms of stenosis of degree III could clinically be improved after the treatment. The average frequence of dilatation was 1.5 ×, complications such as bleeding or perforation were not registered. Animal studies explain anastomotic stenosis through an increased submucosal formation of collagen fibers followed by formation of scars in the anastomosis. The efficiency of electroincision and balloon dilatation is based on an increased diameter in the anastomotic region without increased formation of new collagen fibers.

Summary Palliative tube implantation after bougienage of a malignant oesophageal stenosis was used to treat 46 patients. In 22 cases this was done by endoscopy, in the other cases by operation. In this study different techniques of implantation are compared regarding complications (mortality, perforations, hemorrhages, dislocation and occlusion of the tube, and pulmonary complications), as well as length of hospital stay, survival rate, and costs. Implantation by endoscopy proves superior to implantation by operation regarding length and costs of hospital stay (7 days to 26), lethality in the clinic (9.5% to 28%), and postoperative morbidity (pulmonary complications and disturbances in wound healing).