Abstract：
OBJECTIVE: The standard therapies for benign gastrointestinal stenosis are endoscopic balloon dilation or surgery; each have their advantages and disadvantages. In contrast, radial incision and cutting (RIC) is a novel approach for such stenosis. This study aimed to investigate the feasibility, safety, and effectiveness of RIC.
METHODS: We enrolled 20 patients with benign stenosis of the lower gastrointestinal tract developed by various causes and conducted RIC. We evaluated the re-intervention free rate 52 weeks after RIC, technical success rate, adverse events, procedure time, and improvement of symptoms using a visual analog scale.
RESULTS: We performed 20 sessions of first RIC for 20 lesions and seven sessions of additional RIC due to re-stenosis. The cumulative re-intervention-free survival rate 52 weeks after the first RIC was 55.8%. The technical success rate of the first RIC was 100% (20/20) while that of the additional RIC was 85.7% (6/7). One case developed perforation during the additional RIC and urgent surgery was performed. The additional RIC tended to show worse results in adverse events and procedure time compared with the first RIC. The patients\' symptoms including abdominal bloating and dyschezia were significantly improved.
CONCLUSIONS: Although RIC demonstrated a higher technical success rate for lower gastrointestinal stricture and subsequent improvement of patient symptoms, several issues including preventing delayed bleeding, perforation, and the long-term prognosis should be solved and clarified in further investigations.
METHODS: We enrolled 20 patients with benign stenosis of the lower gastrointestinal tract developed by various causes and conducted RIC. We evaluated the re-intervention free rate 52 weeks after RIC, technical success rate, adverse events, procedure time, and improvement of symptoms using a visual analog scale.
RESULTS: We performed 20 sessions of first RIC for 20 lesions and seven sessions of additional RIC due to re-stenosis. The cumulative re-intervention-free survival rate 52 weeks after the first RIC was 55.8%. The technical success rate of the first RIC was 100% (20/20) while that of the additional RIC was 85.7% (6/7). One case developed perforation during the additional RIC and urgent surgery was performed. The additional RIC tended to show worse results in adverse events and procedure time compared with the first RIC. The patients\' symptoms including abdominal bloating and dyschezia were significantly improved.
CONCLUSIONS: Although RIC demonstrated a higher technical success rate for lower gastrointestinal stricture and subsequent improvement of patient symptoms, several issues including preventing delayed bleeding, perforation, and the long-term prognosis should be solved and clarified in further investigations.
摘要：
目的：良性胃肠道狭窄的标准治疗方法是内镜下球囊扩张术或手术；每种方法都有其优缺点。相比之下,径向切开和切割（RIC）是一种新颖的方法，这种狭窄。本研究旨在探讨其可行性，安全,和RIC的有效性。
方法：我们招募了20例由各种原因引起的下胃肠道良性狭窄患者，并进行了RIC。我们评估了RIC后52周的再干预自由率，技术成功率,不良事件,程序时间,并使用视觉模拟量表改善症状。
结果：我们对20个病变进行了20次首次RIC治疗，对再狭窄进行了7次额外RIC治疗。首次RIC后52周的累积无再干预生存率为55.8%。第一个RIC的技术成功率为100％（20/20），而附加RIC的技术成功率为85.7％（6/7）。一例病例在额外的RIC期间发生穿孔，并进行了紧急手术。与第一个RIC相比，额外的RIC倾向于在不良事件和手术时间方面显示更差的结果。患者的腹胀、气胀等症状明显改善。
结论：尽管RIC在下消化道狭窄和随后患者症状改善方面显示出更高的技术成功率，几个问题，包括预防延迟出血，穿孔,长期预后应在进一步的研究中解决和澄清。
方法：我们招募了20例由各种原因引起的下胃肠道良性狭窄患者，并进行了RIC。我们评估了RIC后52周的再干预自由率，技术成功率,不良事件,程序时间,并使用视觉模拟量表改善症状。
结果：我们对20个病变进行了20次首次RIC治疗，对再狭窄进行了7次额外RIC治疗。首次RIC后52周的累积无再干预生存率为55.8%。第一个RIC的技术成功率为100％（20/20），而附加RIC的技术成功率为85.7％（6/7）。一例病例在额外的RIC期间发生穿孔，并进行了紧急手术。与第一个RIC相比，额外的RIC倾向于在不良事件和手术时间方面显示更差的结果。患者的腹胀、气胀等症状明显改善。
结论：尽管RIC在下消化道狭窄和随后患者症状改善方面显示出更高的技术成功率，几个问题，包括预防延迟出血，穿孔,长期预后应在进一步的研究中解决和澄清。
