Successful Endoscopic Incision for a Membranous Obstruction of the Anastomosis after Surgical Treatment of Rectal Cancer: Report of Two Cases

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  • Hayashi Yuko
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Chino Akiko
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Fujimoto Yoshiya
    Department of Gastroenterological Surgery, The Cancer Institute Hospital of JFCR
  • Ishikawa Hirotaka
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Kishihara Teruhito
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Uragami Naoyuki
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Tamegai Yoshiro
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Igarashi Masahiro
    Department of Gastroenterology, The Cancer Institute Hospital of JFCR
  • Takahashi Hiroshi
    Department of Gastroenterology, Showa University Fujigaoka Hospital
  • Ueno Masashi
    Department of Gastroenterological Surgery, The Cancer Institute Hospital of JFCR

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Other Title
  • 直腸癌術後の膜様閉鎖に内視鏡的切開術が有用であった2例

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Abstract

Nowadays, intersphincteric resection (ISR) is widely performed for rectal cancer. Although post-surgical stenosis of the anastomosis is occasionally observed, most stenotic lesions can be easily treated with endoscopic balloon dilatation or finger bougienage. We report on two patients with membranous obstruction of the anastomosis after surgery for rectal cancer. In both of these cases, endoscopic incision with a needle knife was effective. The first patient, who had undergone pre-surgical chemoradiation therapy followed by an intersphincteric resection, developed membranous complete obstruction of the anastomosis. We penetrated the atretic lesion with biopsy forceps, and an incision was made with a needle knife. This lesion was successfully treated with balloon dilatation. For the other patient, the post-surgical membranous obstruction was favorably treated with finger bougienage following an incision with a needle knife.

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