Use of the endostapler for the treatment of non-healing sinus secondary to a dehisced colorectal anastomosis.
BACKGROUND
A dehisced colorectal anastomosis complicated by a sinus, especially after preoperative radiation for colorectal cancer, may not heal. We describe our experience in the management of such a condition using the endoscopic surgical stapler.


METHODS
Patients who underwent low anterior resection for rectal cancer after preoperative chemoradiation and who developed a dehisced anastomosis complicated by a chronic posterior sinus underwent the procedure. After exclusion of cancer recurrence, the common wall between the sinus and the rectal lumen was stapled using the endoscopic surgical stapler.


RESULTS
Four patients received the day-surgery treatment. Healing of the sinus was confirmed in all patients using a contrast enema. Median time to healing was 10 weeks. All patients had a diverting ileostomy which was eventually closed. No complications were noted.


CONCLUSIONS
Stapling the common wall between the sinus and the rectal lumen after a dehisced anastomosis is a viable option in the treatment of chronic posterior sinuses when coupled with fecal diversion.
Alsanea
N
N
Colon and Rectal Surgery, King Faisal Specialist Hospital and Research Center, MBC-40, P.O. Box 3354, Riyadh, 11211, Saudi Arabia. nsanea@kfshrc.edu.sa
Alabbad
S
S
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D003106:Colon / Q000601:surgery; D003107:Colorectal Surgery / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D017792:Surgical Stapling; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing