Usefulness of flexible colonoscopic microwave coagulation therapy for a colorectal anastomotic stricture.
OBJECTIVE
Several methods of treatment for benign anastomotic strictures after anterior resection have been described. We describe a simple, safe, effective, and inexpensive method for treating benign colorectal anastomotic stricture by means of microwave coagulation under flexible colonoscopic visualization.


METHODS
Eighteen patients with rectal or rectosigmoidal cancer underwent low anterior resection or anterior resection without colonic pouch and colorectal anastomosis by a double-stapling technique with PCEEA. Two of 18 patients (11.1 percent) developed an anastomotic stenosis. A microwave electrode was passed through the biopsy channel of the flexible colonoscope. Under flexible colonoscopic visualization, microwave irradiation was performed at four points (3, 6, 9, and 12 o'clock) in the stricture site because of granulation scar to obtain an adequately coagulated area. No bougies were performed thereafter.


RESULTS
The anastomotic strictures could be dilated adequately, the patients could defecate satisfactorily, and their abdominal distentions and bowel symptoms were resolved. No complications occurred. No occurrence of restricture has been observed.


CONCLUSIONS
Flexible endoscopic, microwave coagulation therapy is a useful, simple, effective, and safe method for the treatment of benign colorectal anastomotic strictures.
Takeuchi
Kunio
K
Department of Surgery, Tone Chuo Hospital, Gunma University School of Medicine, Gunma, Japan.
Tsuzuki
Yasushi
Y
Ando
Tetsu
T
Sekihara
Masao
M
Hara
Takashi
T
Kori
Takayuki
T
Nakajima
Hiroki
H
Asao
Takayuki
T
Kuwano
Hiroyuki
H
D000714:Anastomosis, Surgical / Q000009:adverse effects; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D013528:Surgical Staplers