Successful treatment of a rectal anastomotic stenosis by transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser

Surg Endosc. 1997 May;11(5):485-7. doi: 10.1007/s004649900398.

Abstract

We report the advantage of employing transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser for the treatment of a rectal anastomotic stenosis. A 72-year-old woman was admitted to our hospital with a postoperative rectal anastomotic stenosis. Twenty months prior to admission, the patient underwent a low anterior resection for the treatment of the rectal cancer using an EEA stapling device. A barium enema and colonoscopy revealed a rectal stenosis, 0.8-cm diameter. This stenosis was at the anastomotic site, approximately 4.0 from the dental line. An endoscopic treatment was performed transanally using the contact Nd:YAG laser. The stenotic rectal wall was fulgurated or vaporized completely. There were no intraoperative or postoperative complications. We concluded that TEM appears to be a safe and minimally invasive procedure. Furthermore, the contact Nd:YAG laser is very effective in treating the gastrointestinal stenotic area. To our knowledge, this is the first successful report of this novel procedure.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anal Canal
  • Anastomosis, Surgical / adverse effects
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Endoscopes
  • Endoscopy / methods*
  • Female
  • Humans
  • Laser Therapy / instrumentation
  • Laser Therapy / methods*
  • Microsurgery / instrumentation
  • Microsurgery / methods*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Rectum / pathology
  • Rectum / surgery*