Restoration of colonic patency of a completely obstructed Crohn’s stricture using the combined antegrade-retrograde dilation procedure

Moyer, Matthew T.; Mathew, Abraham; Chintanaboina, Jayakrishna; Williams, Emmanuelle; Puleo, Frances J.; Tinsley, Andrew

doi:10.1016/j.vgie.2017.07.001

Cited by 3 publications

(6 citation statements)

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“…10 Table 1 summarizes all previous reports on complete closure of the anastomosis canal that have been cured by endoscopic approaches. [11][12][13][14][15][16][17][18][19][20] In these studies, all patients underwent endoscopic approaches including balloon dilation and endoscopic cutting by electrocautery with a hook or papillotomy knife, and the strictures were diagnosed when the patients came back for stoma reversal. [11][12][13][14][15][16][17][18][19][20] The two cases in this current report involved complete anastomosis closure in the colon, a region wherein anastomosis tension or ischaemia is seldomly encountered.…”

Section: Discussionmentioning

confidence: 99%

“…In all cases reported in the current literature, the anastomosis was made on the end-to-end. [11][12][13][14][15][16][17][18][19][20] Conversely, in the two current cases, the anastomosis was made on the end-to-side. Therefore, there would be two liner scars inside the lumen of the intestine distal to the anastomosis, namely the anastomosis stenosis and the blind end.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20] In these studies, all patients underwent endoscopic approaches including balloon dilation and endoscopic cutting by electrocautery with a hook or papillotomy knife, and the strictures were diagnosed when the patients came back for stoma reversal. [11][12][13][14][15][16][17][18][19][20] The two cases in this current report involved complete anastomosis closure in the colon, a region wherein anastomosis tension or ischaemia is seldomly encountered. Interestingly, the current cases involved a unique type of stenosis that developed without affecting the proximal side of the anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…In all cases reported in the current literature, the anastomosis was made on the end-to-end. [11][12][13][14][15][16][17][18][19][20] Conversely, in the two current cases, the anastomosis…”

Section: Discussionmentioning

confidence: 99%

“…Summary of the studies that reported on the treatment of complete anastomotic stenosis (COS) [11][12][13][14][15][16][18][19][20] …”

mentioning

confidence: 99%

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Endoscopic diagnosis and treatment of complete anastomosis stenosis after colorectal resection without protective ileostomy: report of two cases and literature review

Deng

Cao

et al. 2020

J Int Med Res

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This case report describes a novel procedure for opening the lumen of a completely obstructed anastomosis when open surgery is not an option. Two patients underwent ileocecal or colorectal resection and one-stage anastomosis reconstruction without diverging ileostomy. The patients developed post-surgical abdominal distension and nausea. Emergency imaging indicated complete anastomotic obstruction and distal intestinal anastomosis emptiness. Colonoscopy revealed an anastomosis that was completely discontinued by a membranous structure. Considering that open surgery was not a viable treatment option, a minimally invasive endoscopic approach was adopted to repair the obstruction. A needle knife was used to puncture the linear white scar and contrast agent was injected under endoscopy and fluoroscopic guidance. Fluoroscopically, the proximal bowel was identified and a dual knife-mediated membrane puncture was performed. A guidewire was then passed through the incision into the proximal bowel and progressive pneumatic dilatation was performed successively with a controlled radial expansion balloon dilator until a 1.8 cm diameter dilation was achieved. After conventional balloon dilatation, the

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…In all cases reported in the current literature, the anastomosis was made on the end-to-end. [11][12][13][14][15][16][17][18][19][20] Conversely, in the two current cases, the anastomosis…”

Section: Discussionmentioning

confidence: 99%

“…Summary of the studies that reported on the treatment of complete anastomotic stenosis (COS) [11][12][13][14][15][16][18][19][20] …”

mentioning

confidence: 99%

See 3 more Smart Citations

Endoscopic diagnosis and treatment of complete anastomosis stenosis after colorectal resection without protective ileostomy: report of two cases and literature review

Deng

Cao

et al. 2020

J Int Med Res

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Novel use of lumen-apposing metal stent for recanalization of complete stenosis of colo-colonic anastomosis

2023

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

Deng

Cao

et al. 2021

BMC Surg

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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.

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Restoration of colonic patency of a completely obstructed Crohn’s stricture using the combined antegrade-retrograde dilation procedure

Cited by 3 publications

References 0 publications

Endoscopic diagnosis and treatment of complete anastomosis stenosis after colorectal resection without protective ileostomy: report of two cases and literature review

Endoscopic diagnosis and treatment of complete anastomosis stenosis after colorectal resection without protective ileostomy: report of two cases and literature review

Novel use of lumen-apposing metal stent for recanalization of complete stenosis of colo-colonic anastomosis

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

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