Two Cases of Endoscopic Clipping for Anastomotic Leakage Found by Intraoperative Colonoscopy during Laparoscopic Rectal Surgery

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  • Takahara Yoshihiro
    Department of Surgery, Japan Community Health Care Organization Funabashi Central Hospital
  • Shida Takashi
    Department of Surgery, Japan Community Health Care Organization Funabashi Central Hospital
  • Ogasawara Takeshi
    Department of Surgery, Japan Community Health Care Organization Funabashi Central Hospital
  • Nomura Satoru
    Department of Surgery, Japan Community Health Care Organization Funabashi Central Hospital
  • Otsuka Yasuhiro
    Department of Surgery, Japan Community Health Care Organization Funabashi Central Hospital
  • Takahashi Makoto
    Department of Surgery, Japan Community Health Care Organization Funabashi Central Hospital

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  • 腹腔鏡補助下直腸切除時の術中内視鏡により見つかった縫合不全に対して内視鏡下クリッピングを施行した2例

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Abstract

Postoperative anastomotic leakage is one of the major complications which can result in serious morbidity in colorectal surgery. In our institution, we routinely perform intraoperative colonoscopy (IOCS) for the direct inspection of the double-stapling-technique (DST) anastomosis to check its patency. Here, we report 2 cases of anastomotic leakage found by IOCS and well managed by endoscopic clipping simultaneously. The sites of anastomotic leakage were clearly recognized by IOCS and were successfully closed by endoscopic clipping. After the endoscopic clipping, the leak-test result of IOCS was negative, therefore we did not construct ileostomy or colostomy. Both cases showed no postoperative anastomotic leakage. Direct suturing closure or re-anastomosis is usually performed for anastomotic leakage found during the operation. However sometimes it may be difficult depending on the location of the anastomosis site. It seems that endoscopic closure by clipping may be useful for preventing anastomotic leakage in rectal surgery.

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