Endoscopic microwave coagulation therapy of postoperative hemorrhage from a stapled anastomosis.
We experienced three cases of postoperative hemorrhage from a stapled gastrointestinal anastomosis, and established endoscopic microwave coagulation therapy (EMCT) with a cylinder-type electrode. We were able to treat postoperative hemorrhage over the entire circumference of stapled anastomosis successfully. Two patients had undergone a lower third thoracic esophagogastrectomy through a left thoraco-abdominal approach for gastric cancer in the cardia, while the other case had undergone Billroth I gastrectomy. They each had fresh bleeding from the stapled anastomosis after the operation. Emergency endoscopic examination was immediately performed. Endoscopy revealed bleeding on the suture line. We performed hemostasis endoscopically with microwave coagulation therapy safely. They were discharged from the hospital without complications such as leakage and stenosis. Since EMCT with the cylinder-type electrode can coagulate shallowly and widely, it is very effective for hemorrhage from a stapled anastomosis.
Umano
Yasukazu
Y
Department of Surgery, National Hospital Organization Osaka Minami Medical Center, Japan. y525umano@hotmail.com
Horiuchi
Tetsuya
T
Inoue
Masaya
M
Shono
Yoshiharu
Y
Oku
Yoshimasa
Y
Tanishima
Hiroyuki
H
Tsuji
Takeshi
T
Tabuse
Katsuyoshi
K
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D003131:Combined Modality Therapy; D004564:Electrocoagulation / Q000379:methods*; D016629:Esophagectomy / Q000379:methods; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013156:Splenectomy / Q000379:methods; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery; D017792:Surgical Stapling / Q000009:adverse effects; D016896:Treatment Outcome