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Related Concept Videos

Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Esophageal Strictures-II: Clinical Features and Management01:26

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408
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Vessel-sparing Excision and Primary Anastomosis
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Circumferential Rectal Cancer Is a Risk Factor for Stricture Formation and Restaging Uncertainties After Neoadjuvant

James G Connolly1, James C McCullum, Cody Munroe

  • 1Division of Colon and Rectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts.

Diseases of the Colon and Rectum
|November 5, 2025
PubMed
Summary
This summary is machine-generated.

Rectal cancer patients undergoing total neoadjuvant therapy who develop strictures after treatment have a high likelihood of residual disease. This finding complicates non-operative management options for these patients.

Keywords:
CircumferentialNonoperative managementRectal cancerStrictureTotal neoadjuvant therapy

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Area of Science:

  • Oncology
  • Surgical Gastroenterology
  • Radiation Oncology

Background:

  • Total neoadjuvant therapy (TNT) for rectal cancer can lead to strictures, complicating clinical response assessment.
  • Strictures are currently a contraindication for non-operative management per National Comprehensive Cancer Network guidelines.
  • The incidence of stricture formation and occult residual disease post-TNT is not well understood.

Purpose of the Study:

  • To identify patients at risk for rectal stricture formation following TNT.
  • To assess the rate of residual tumor in strictures after TNT.

Main Methods:

  • Retrospective study at a single tertiary care center.
  • Included Stage II or III rectal cancer patients treated with TNT and curative intent surgery.
  • Analyzed stricture formation rate and pathologic complete response after proctectomy.

Main Results:

  • 18 of 69 patients (26%) had circumferential rectal tumors; 4 (22%) developed post-treatment strictures.
  • All 4 stricture patients underwent proctectomy due to concern for residual disease, with 3 (75%) confirmed to have residual disease.
  • 14 circumferential tumor patients without strictures underwent proctectomy, with 11 (79%) showing incomplete response.

Conclusions:

  • Post-treatment rectal strictures in patients receiving TNT are associated with a high rate of residual disease (75%).
  • This challenges the feasibility of non-operative management in patients who develop strictures after TNT.
  • Further research is needed due to the limited sample size.