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

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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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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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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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/v3 ◽

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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Quality of life after rectal cancer surgery (systematic review)

Koloproktologia ◽

10.33878/2073-7556-2021-20-1-59-67 ◽

2021 ◽

Vol 20 (1) ◽

pp. 59-67

Author(s):

A. B. Serebriy ◽

E. A. Khomyakov ◽

I. O. Nafedzov ◽

O. Yu. Fomenko ◽

E. G. Rybakov

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Life Quality ◽

Cancer Surgery ◽

Rectal Cancer Surgery ◽

Low Anterior Resection Syndrome

Aim: search for modifiable and unmodifiable risk factors affecting the quality of life of patients after rectal cancer surgery.Materials and methods: the literature search was done according to the keywords: quality of life, rectal cancer, low anterior resection syndrome. Twelve prospective randomized studies, 2 cohort studies, and 2 meta-analyses are included in the study. The quality of life was assessed in the analyzed studies by using questionnaires for cancer patients and updated questionnaires for colorectal cancer: EORTC QLQ-CR29, QLQ-C30, QLQ-CR38, BIQ.Results: the literary data on influence of gender, age, surgery, stoma, and chemoradiotherapy on life quality of patients after rectal cancer surgery was analyzed.Conclusion: the most significant factor affecting the life quality of patients with rectal cancer is a violation of the body image if it is necessary to form the stoma on the anterior abdominal wall. The manifestations of the low anterior resection syndrome and the urination problems are significant risk factors in the case of restoration of bowel continuity.

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Outcomes on diverting ostomy formation and reversal after low anterior resection in the older more advanced rectal cancer patient

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2021.12.020 ◽

2021 ◽

Author(s):

S.H.J. Ketelaers ◽

R.G. Orsini ◽

G.A.P. Nieuwenhuijzen ◽

H.J.T. Rutten ◽

J.W.A. Burger ◽

...

Keyword(s):

Rectal Cancer ◽

Cancer Patient ◽

Anterior Resection ◽

Low Anterior Resection ◽

Rectal Cancer Patient ◽

Advanced Rectal Cancer ◽

Diverting Ostomy

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The effect of rectal washout on local recurrence following rectal cancer surgery

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0202 ◽

2018 ◽

Vol 100 (2) ◽

pp. 146-151 ◽

Cited By ~ 1

Author(s):

SR Moosvi ◽

K Manley ◽

J Hernon

Keyword(s):

Rectal Cancer ◽

Local Recurrence ◽

Anterior Resection ◽

High Volume ◽

Conclusive Evidence ◽

Rectal Cancer Surgery ◽

Single Institution ◽

Recurrence Rates ◽

Rectal Washout ◽

Significant Difference

Introduction Local recurrence after surgery for rectal cancer is associated with significant morbidity and debilitating symptoms. Intraoperative rectal washout has been linked to a reduction in local recurrence but there is no conclusive evidence. The aim of this study was to evaluate whether performing rectal washout had any effect on the incidence of local recurrence in patients undergoing anterior resection for rectal cancer in the context of the current surgical management. Methods A total of 395 consecutive patients who underwent anterior resection with or without rectal washout for rectal cancer between January 2003 and July 2009 at a high volume single institution were analysed retrospectively. A standardised process for performing washout was used and all patients had standardised surgery in the form of total mesorectal excision. Neoadjuvant and adjuvant therapy was used on a selected basis. Patients were followed up for five years and local recurrence rates were compared in the two groups. Results Of the 395 patients, 297 had rectal washout and 98 did not. Both groups were well matched with regard to various important clinical, operative and histopathological characteristics. Overall, the local recurrence rate was 5.3%. There was no significant difference in the incidence of local recurrence between the washout group (5.7%) and the no washout group (4.1%). Conclusions Among our cohort of patients, there was no statistical difference in the incidence of local recurrence after anterior resection with or without rectal washout. This suggests that other factors are more significant in the development of local recurrence.

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