Application of endoscopic technique in completely occluded anastomosis with anastomotic separation after radical resection of colon cancer: a case report and literature review

Abstract

Background Anastomosis-related complications are common after the radical resection of colon cancer. Among such complications, severe stenosis or completely occluded anastomosis (COA) are uncommon in clinical practice, and the separation of the anastomosis is even rarer. For such difficult problems as COA or anastomotic separation, clinicians tend to adopt surgical interventions, and few clinicians try to solve them through endoscopic operations. Case presentation In this article, we present a case of endoscopic treatment of anastomotic closure and separation after radical resection for sigmoid carcinoma. After imaging examination and endoscopic evaluation, we found that the patient had a COA accompanied by a 3–4 cm anastomotic separation. With the aid of fluoroscopy, we attempted to use the titanium clip marker as a guide to perform an endoscopic incision and successfully achieved recanalization. We used a self-expanding covered metal stent to bridge the intestinal canal to resolve the anastomotic separation. Finally, the patient underwent ileostomy takedown, and the postoperative recovery was smooth. The follow-up evaluation results showed that the anastomotic stoma was unobstructed. Conclusions We reported the successful application of endoscopic technique in a rare case of COA and separation after colon cancer surgery, which is worth exploring and verifying through more clinical studies in the future.

Treatment of a recurrent rectal anastomotic stenosis

“…The treatment of stricture due to anastomotic leak can frequently fail if it is performed by simple endoscopic incising, because the area around the anastomosis is often in a state of inflammatory hyperplasia. 1,2 Although covered stents have been used for anastomotic leak, their complications must be taken into account when used on strictures that approach the anus. These include pain, diarrhoea, and swelling.…”

Comparing the short-term results of the improved triangular anastomosis technique for complete laparoscopic radical resection of sigmoid colon cancer and laparoscopic-assisted small incision colon reconstruction: A CONSORT study

“…To a certain extent, the difficulty of the operation and the risk of infection are increased. [ 17 ] With the continuous improvement of laparoscopic technology, complete laparoscopic surgery can be promoted and applied in clinical practice. It means that with the assistance of laparoscopy, the surgeon completes all surgical operations including the reconstruction of the digestive tract in the patient.…”

Rendezvous endoscopy using a transillumination fashion as a feasible and safe alternative to endoscopic ultrasound‐guided recanalization in case of complete anastomotic stricture

“…Thus far, only few cases of dilation of complete anastomotic stricture by a combined antegrade and retrograde fashion have been described. 1,2 The main take-home message of our brief report should be to remind readers about taking always into consideration all the endoscopic choices available before reintervention, checking the current literature! 1,2 drafting the article, and final approval of the version to be published.…”

“…1,2 The main take-home message of our brief report should be to remind readers about taking always into consideration all the endoscopic choices available before reintervention, checking the current literature! 1,2 drafting the article, and final approval of the version to be published. Luca Talamucci involved in study design, data analysis, drafting the article, and final approval of the version to be published.…”

“… 1 , 2 The main take‐home message of our brief report should be to remind readers about taking always into consideration all the endoscopic choices available before reintervention, checking the current literature! 1 , 2 …”