Successful treatment of a rectal anastomotic stenosis by transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser.
We report the advantage of employing transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser for the treatment of a rectal anastomotic stenosis. A 72-year-old woman was admitted to our hospital with a postoperative rectal anastomotic stenosis. Twenty months prior to admission, the patient underwent a low anterior resection for the treatment of the rectal cancer using an EEA stapling device. A barium enema and colonoscopy revealed a rectal stenosis, 0.8-cm diameter. This stenosis was at the anastomotic site, approximately 4.0 from the dental line. An endoscopic treatment was performed transanally using the contact Nd:YAG laser. The stenotic rectal wall was fulgurated or vaporized completely. There were no intraoperative or postoperative complications. We concluded that TEM appears to be a safe and minimally invasive procedure. Furthermore, the contact Nd:YAG laser is very effective in treating the gastrointestinal stenotic area. To our knowledge, this is the first successful report of this novel procedure.
Kato
K
K
Second Department of Surgery, Asahikawa Medical College, 4-5 Nishi-Kagura, Asahikawa, 078 Japan.
Saito
T
T
Matsuda
M
M
Imai
M
M
Kasai
S
S
Mito
M
M
D000368:Aged; D001003:Anal Canal; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery*