A CASE OF A RECTAL ANASTOMOTIC STRICTURE TREATED WITH AN ENDOSCOPIC DIODE LASER

DOI 2 Citations 20 References
  • SATO Sumito
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • ISHIDA Yasuo
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • HATAKEYAMA Toshiyuki
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • OGA Junichi
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • NAKADA Takao
    Department of Gastroenterology, Yokohama Asahi Chuo General Hospital.
  • NAGAYAMA Hiroyuki
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • WASEDA Masahiro
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • WATANABE Mitsuyuki
    Department of Gastroenterology, Yokohama Asahi Chuo General Hospital.
  • HATAYA Kiyoshi
    Department of Surgery, Yokohama Asahi Chuo General Hospital.
  • NAKANO Hiroshi
    Department of Surgery, Yokohama Asahi Chuo General Hospital. Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital.

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Other Title
  • 直腸癌術後の難治性吻合部狭窄に対して内視鏡下半導体レーザー治療が著効した1例

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A 70-year-old male had undergone low anterior resection for rectal cancer. Anastomotic leakage after the surgery had induced a severe anastomotic stricture making defecation difficult and which had proved resistant to several treatment attempts with balloon dilation and bougienage. Colonoscopy and a Gastrografin enema examination demonstrated a pinhole stenosis of the anastomosis. As there was no cancer recurrence around the stricture, endoscopic diode laser therapy was then selected.<BR>We used a compact diode laser system (UDL-60 Olympus) via colonoscopy. Although this system has equal clinical advantages to the Nd : YAG laser, it is smaller and more portable. The colonoscope was introduced into the rectum, and was positioned optimally to the rectal stenosis. The tissue surrounding the stenosis was penetrated using the contact endoprobe of the diode laser system, and removed with biopsy forceps. No complications such as bleeding or perforation occurred. After the treatment, the stenosis had improved and good progress was maintained for 1 year and 9 months without any recurrence. We therefore concluded that endoscopic diode laser therapy could be one of the promising treatment options for severe anastomotic rectal strictures.

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