Novel treatment of intractable rectal strictures associated with anastomotic leakage using a stenosis-cutting device.
Disruption of an anastomosis after a low anterior resection reconstructed by a double stapling technique is a relatively rare complication but leads to a severe anastomotic stricture. Furthermore, this type of stricture is usually resistant to conventional treatment. A previously developed type of staple cutter (STENO-CUTTER) was applied in order to evaluate the clinical effects for the treatment of severe rectal stricture associated with anastomotic leakage. The incidence of leakage was 11 out of 371 patients (3.0%). The incidence of subsequent stricture in the leakage group (54.5%) was significantly higher than that in the nonleakage group (6.7%; P < 0.0001). Six out of 11 patients with leakage had anastomotic stricture with the distressing symptoms of frequent bowel movements and ileus. Excellent dilation was performed in all of the six strictures using the STENO-CUTTER. Because of the excellent efficacy, in addition to safe and easy use, this treatment is highly recommended for stricture of the rectum associated with anastomotic leakage.
Shimada
Shinya
S
Department of Surgery, Kumamoto City Hospital, Kumamoto, Japan. shimadas443@hotmail.com
Yagi
Yasushi
Y
Yamamoto
Kenichiro
K
Matsuda
Masakazu
M
Baba
Hideo
H
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D003106:Colon / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003672:Defecation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D045823:Ileus / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011351:Proctoscopy; D012002:Rectal Diseases / Q000209:etiology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery; D012007:Rectum / Q000601:surgery; D017792:Surgical Stapling / Q000009:adverse effects*; D016896:Treatment Outcome