title: Endoscopic microwave coagulation therapy of postoperative hemorrhage from a stapled anastomosis.
abstract: 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.
authors.affiliation: Department of Surgery, National Hospital Organization Osaka Minami Medical Center, Japan. y525umano@hotmail.com
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Umano
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Masaya
authors.initials: M
authors.lastname: Inoue
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Shono
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Oku
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanishima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuji
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tabuse
mesh_terms: 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