Foley® catheter-assisted endoscopic treatment of severe anastomotic stenosis following anterior resection of the rectum

Abstract Background: Postoperative anastomotic stenosis is a common complication in colorectal cancer patients (3-30%). Complete anastomotic stenosis is rare; however, when it occurs, almost all cases require surgical treatment. We herein report a case in which endoscopic dilation was effective for treating complete anastomotic stenosis after high anterior resection in a rectal cancer patient.Case presentation: The patient was a 67-year-old man who underwent laparoscopic high anterior resection for rectal cancer (Rs, 3/4circ, type2, pT4a, pN0, cM0, fStageII) in May 2018. The postoperative course was good and the patient was discharged on the 12th postoperative day. Subsequently adjuvant chemotherapy was initiated with oral uracil and tegafur plus leucovorin (UFT/LV); however, he complained of frequent defecation and melena after completion of the first course of chemotherapy. Thus, colonoscopy was performed, which revealed anastomotic stenosis. Endoscopic dilation was initially attempted, but failed. Thus, low anterior resection was performed with diverting colostomy. Four additional courses of chemotherapy were administered for one month after surgery. At six months after the second surgery, colonoscopy was performed, and complete anastomotic stenosis was pointed out again. The patient was successfully treated by endoscopic dilation using the rendezvous method. After this treatment, the lumen of the anastomotic site was observed to have narrowed again and endoscopic dilatation to treat anastomotic stenosis was repeated. In addition, he received local injection of steroids in anastomotic stenosis site. The lumen of anastomotic stenosis remained after the local injection of steroids and closure of colostomy was performed nine months after the second operation.Conclusions: Endoscopic dilation using the rendezvous method was effective for treating anastomotic stenosis after colorectal surgery.

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ENDOSCOPIC TREATMENT OF ESOPHAGEAL ANASTOMOTIC STENOSЕS AND LEAKAGES

Inter Collegas ◽

10.35339/ic.7.2.85-88 ◽

2020 ◽

Vol 7 (2) ◽

pp. 85-88

Author(s):

V. Boyko ◽

I. Belozerov ◽

O. Kudrevich ◽

Ye. Novikov ◽

S. Savvi ◽

...

Keyword(s):

Esophageal Cancer ◽

Anastomotic Leakage ◽

Endoscopic Treatment ◽

Proximal Gastrectomy ◽

Esophageal Resection ◽

Anastomotic Stenosis ◽

Endoscopic Stenting ◽

Esophageal Anastomosis ◽

Key Words Gastrectomy ◽

Methods Of Treatment

Abstract ENDOSCOPIC TREATMENT OF ESOPHAGEAL ANASTOMOTIC STENOSЕS AND LEAKAGES Boyko V., Belozerov I., Kudrevich O., Novikov Y., Savvi S., Makarov V., Hroma V., Sаrian I., Korolevska A., Bytyak S., Zhidetskyi V. Endoscopic stenting of esophageal anastomosis due to anastomotic stenosis or leakage is increasingly being used as one of the most effective, minimally invasive and safe methods of treatment. Materials and methods. This research is based on the experience of treatment of 49 patients with gastric and esophageal cancer who previously were operated at the clinic and had complications such as esophageal anastomotic leakage and stenosis. Anastomotic leakage was observed in 21 cases: 9 patients were with gastroesophageal anastomosis, 12 patients were with esophagointestinal anastomosis. Stenosis of esophageal anastomosis were observed in 38 cases: 20 patients were with gastroesophageal anastomosis, 18 patients were with esophagointestinal anastomosis. Results. All patients were undergone endoscopic stenting of esophageal anastomosis. The results of using this method of treatment were estimated. Conclusions. Stenting of the esophagеal anastomosis by coated self-expanding stents is a method of choice in the treatment of patients with esophageal anastomotic leakage and stenosis. Key words: gastrectomy, subtotal proximal gastrectomy, esophageal resection, anastomotic leakage, anastomotic stenosis, stenting of esophageal anastomosis. Резюме. ЕНДОСКОПІЧНЕ ЛІКУВАННЯ СТЕНОЗУ І НЕСПРОМОЖНОСТІ СТРАВОХІДНОГО АНАСТОМОЗУ Бойко В.В., Бєлозьоров І.В., Кудревич О.М., Новіков Є.А., Савви С.О., Макаров В.В., Грома В.Г., Саріан І.В., Королевська А.Ю, Битяк С.Ю., Жидецький В.В. Ендоскопічне стентування стравохідних анастомозів внаслідок стенозу або неспроможності анастомозу все частіше використовується як один з найбільш ефективних, мініінвазивних і безпечних методів лікування. Матеріали та методи. Дане дослідження засноване на досвіді лікування 49 пацієнтів з раком шлунка і стравоходу, які раніше були прооперовані в клініці і мали такі ускладнення, як стеноз або неспроможність анастомозу стравоходу. Неспроможність анастомозу спостерігалася в 21 випадку: 9 пацієнтів з гастроезофагеальним анастомозом, 12 пацієнтів із стравохідно-кишковим анастомозом. Стенози стравохідного анастомозу спостерігалися в 38 випадках: 20 пацієнтів були з гастроезофагеальним анастомозом, 18 пацієнтів були з стравохідно-кишковим анастомозом. Результати. Всім пацієнтам було проведено ендоскопічне стентування стравохідного анастомозу. Результати використання цього методу лікування були оцінені. Висновки. Стентування стравохідних анастомозів покритими саморозширювальними стентами є методом вибору при лікуванні пацієнтів з неспроможністю або стенозом стравохідного анастомозу. Ключові слова: гастректомія, субтотальна проксимальна гастректомія, резекція стравоходу, неспроможність анастомозу, стеноз анастомозу, стентування стравохідного анастомозу. Резюме. ЭНДОСКОПИЧЕСКОЕ ЛЕЧЕНИЕ СТЕНОЗОВ И НЕСОСТОЯТЕЛЬНОСТЕЙ ПИЩЕВОДНЫХ АНАСТОМОЗОВ Бойко В.В., Белозеров И.В., Кудревич А.Н., Новиков Е.А., Савви С.А., Макаров В.В., Грома В.Г., Сариан И.В., Королевская А.Ю, Битяк С.Ю., Жидецкий В.В. Эндоскопическое стентирование пищеводных анастомозов вследствие стеноза или несостоятельности анастомоза все чаще используется как один из наиболее эффективных, миниинвазивных и безопасных методов лечения. Материалы и методы. Данное исследование основано на опыте лечения 49 пациентов с раком желудка и пищевода, которые ранее были прооперированы в клинике и имели такие осложнения, как стеноз или несостоятельность анастомоза пищевода. Несостоятельность анастомоза наблюдалась в 21 случае: 9 пациентов с гастроэзофагеальным анастомозом, 12 пациентов с пищеводно-кишечным анастомозом. Стенозы пищеводного анастомоза наблюдались в 38 случаях: 20 пациентов были с гастроэзофагеальным анастомозом, 18 пациентов были с пищеводно-кишечным анастомозом. Результаты. Всем пациентам было проведено эндоскопическое стентирование пищеводного анастомоза. Результаты использования этого метода лечения были оценены. Выводы. Стентирование пищеводных анастомозов покрытыми саморасширяющимися стентами является методом выбора при лечении пациентов с несостоятельностью или стенозом пищеводного анастомоза. Ключевые слова: гастрэктомия, субтотальная проксимальная гастрэктомия, резекция пищевода, несостоятельность анастомоза, стеноз анастомоза, стентирование пищеводного анастомоза.

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An endoscopic dilation method using the rendezvous approach for the treatment of severe anastomotic stenosis after rectal cancer surgery: A case report

10.21203/rs.3.rs-45601/v2 ◽

2020 ◽

Author(s):

Takuya Nakashima ◽

Nobuhisa Matsuhahshi ◽

Tomonari Suetsugu ◽

Yoshinori Iwata ◽

Shigeru Kiyama ◽

...

Keyword(s):

Rectal Cancer ◽

Anterior Resection ◽

Malignant Tumors ◽

Tnm Classification ◽

Rectal Cancer Patient ◽

Local Injection ◽

Anastomotic Stenosis ◽

Rectal Cancer Surgery ◽

Anastomotic Site ◽

Endoscopic Dilation

Abstract Background: Postoperative anastomotic stenosis is a common complication in colorectal cancer patients (3-30%). Complete anastomotic stenosis is rare; however, when it occurs, almost all cases require surgical treatment. We herein report a case in which endoscopic dilation was effective for treating complete anastomotic stenosis after high anterior resection in a rectal cancer patient.Case presentation: The patient was a 67-year-old man who underwent laparoscopic high anterior resection for rectal cancer (RS, T4a, N0, M0, Stage IIB (TNM Classification of Malignant Tumors)) in May 2018. The postoperative course was good and the patient was discharged on the 12th postoperative day. Subsequently adjuvant chemotherapy was initiated with oral uracil and tegafur plus leucovorin (UFT/LV); however, he complained of frequent defecation and melena after completion of the first course of chemotherapy. Thus, colonoscopy was performed, which revealed anastomotic stenosis. Endoscopic dilation was initially attempted, but failed. Thus, low anterior resection was performed with diverting colostomy. Four additional courses of chemotherapy were administered for one month after surgery. At six months after the second surgery, colonoscopy was performed, and complete anastomotic stenosis was pointed out again. The patient was successfully treated by endoscopic dilation using the rendezvous method. After this treatment, the lumen of the anastomotic site was observed to have narrowed again and endoscopic dilatation to treat anastomotic stenosis was repeated. In addition, he received local injection of steroids in anastomotic stenosis site. The lumen of anastomotic stenosis remained after the local injection of steroids and closure of colostomy was performed nine months after the second operation.Conclusions: Endoscopic dilation using the rendezvous method was effective for treating anastomotic stenosis after colorectal surgery.

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Risk factors of recurrence and de novo incontinence following endoscopic treatment of vesico-urethral anastomotic stenosis

European Urology Supplements ◽

10.1016/s1569-9056(19)31220-5 ◽

2019 ◽

Vol 18 (1) ◽

pp. e1680-e1681

Author(s):

C.M. Rosenbaum ◽

P. Reiss ◽

M. Vetterlein ◽

M. Fisch ◽

J. Kranz ◽

...

Keyword(s):

Risk Factors ◽

Endoscopic Treatment ◽

De Novo ◽

Anastomotic Stenosis

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An endoscopic dilation method using the rendezvous approach for the treatment of severe anastomotic stenosis after rectal cancer surgery: a case report

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02062-9 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Takuya Nakashima ◽

Nobuhisa Matsuhashi ◽

Tomonari Suetsugu ◽

Yoshinori Iwata ◽

Shigeru Kiyama ◽

...

Keyword(s):

Rectal Cancer ◽

Anterior Resection ◽

Malignant Tumors ◽

Tnm Classification ◽

Rectal Cancer Patient ◽

Local Injection ◽

Anastomotic Stenosis ◽

Rectal Cancer Surgery ◽

Anastomotic Site ◽

Endoscopic Dilation

Abstract Background Postoperative anastomotic stenosis is a common complication in colorectal cancer patients (3–30%). Complete anastomotic stenosis is rare; however, when it occurs, almost all cases require surgical treatment. We herein report a case in which endoscopic dilation was effective for treating complete anastomotic stenosis after high anterior resection in a rectal cancer patient. Case presentation The patient was a 67-year-old man who underwent laparoscopic high anterior resection for rectal cancer (RS, T4a, N0, M0, Stage IIB (TNM Classification of Malignant Tumors)) in May 2018. The postoperative course was good and the patient was discharged on the 12th postoperative day. Subsequently adjuvant chemotherapy was initiated with oral uracil and tegafur plus leucovorin (UFT/LV); however, he complained of frequent defecation and melena after completion of the first course of chemotherapy. Thus, colonoscopy was performed, which revealed anastomotic stenosis. Endoscopic dilation was initially attempted, but failed. Thus, low anterior resection was performed with diverting colostomy. Four additional courses of chemotherapy were administered for 1 month after surgery. At 6 months after the second surgery, colonoscopy was performed, and complete anastomotic stenosis was pointed out again. The patient was successfully treated by endoscopic dilation using the rendezvous method. After this treatment, the lumen of the anastomotic site was observed to have narrowed again and endoscopic dilatation to treat anastomotic stenosis was repeated. In addition, he received local injection of steroids in anastomotic stenosis site. The lumen of anastomotic stenosis remained after the local injection of steroids and closure of colostomy was performed 9 months after the second operation. Conclusions Endoscopic dilation using the rendezvous method was effective for treating anastomotic stenosis after colorectal surgery.

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