N Alsanea1, S Alabbad. 1. 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
Abstract
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. CONCLUSION: 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.
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. CONCLUSION: 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.