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World J Gastrointest Pathophysiol. Jun 22, 2025; 16(2): 107492
Published online Jun 22, 2025. doi: 10.4291/wjgp.v16.i2.107492
Pathophysiology of anastomotic stricture following rectal anastomosis: Insights into mechanisms, risk factors, and preventive strategies
Ahmet Yavuz, Hikmet Pehlevan-Özel, Mesut Tez
Ahmet Yavuz, Hikmet Pehlevan-Özel, Department of Surgery, Ankara Bilkent City Hospital, Ankara 06800, Türkiye
Mesut Tez, Department of Surgery, University of Health Sciences, Ankara City Hospital, Ankara 06800, Türkiye
Author contributions: Yavuz A was responsible for conceptualization, methodology, data curation, writing – original draft preparation; Pehlevan-Özel H was responsible for investigation, formal analysis, visualization, writing – review & editing; Tez M was responsible for supervision, project administration, validation, writing – review & editing; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose. There are no financial, personal, or professional relationships that could be perceived to influence the work presented in this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mesut Tez, Professor, Department of Surgery, University of Health Sciences, Ankara City Hospital, No. 1 Bilkent Street, District of Universities, Ankara 06800, Türkiye. mesuttez@yahoo.com
Received: March 25, 2025
Revised: March 28, 2025
Accepted: May 8, 2025
Published online: June 22, 2025
Processing time: 86 Days and 21.1 Hours
Core Tip

Core Tip: Anastomotic stricture following rectal anastomosis is a multifactorial complication driven by fibrosis, inflammation, anastomotic leakage, radiotherapy, and ischemia. This review highlights the pathophysiological mechanisms, including excessive collagen deposition and transforming growth factor-beta activation, and identifies key risk factors such as neoadjuvant radiotherapy and surgical technique. Preventive strategies, such as preserving blood supply and using standardized stapling techniques, are emphasized to improve patient outcomes and reduce stricture incidence.