Zhang Miao-Miao, Sha Huan-Chen, Qin Yuan-Fa, Lyu Yi, Yan Xiao-Peng
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
World J Gastroenterol. 2024 Feb 14;30(6):599-606. doi: 10.3748/wjg.v30.i6.599.
Treatment of postoperative anastomotic stenosis for colorectal cancer is often challenging, especially for patients who do not respond well to endoscopy. In cases where patients have undergone an enterostomy, the stenosis can be easily resolved through magnetic compression. However, common magnetic compression techniques cannot be performed on those without enterostomy. We designed a novel Y-Z deformable magnetic ring (Y-Z DMR) and successfully applied it to a patient with a stenosis rectal anastomosis and without enterostomy after rectal cancer surgery.
We here report the case of a 57-year-old woman who had undergone a laparoscopic radical rectum resection (Dixon) for rectal cancer. However, she started facing difficulty in defecation 6 months after surgery. Her colonoscopy indicated stenosis of the rectal anastomosis. Endoscopic balloon dilation was performed six times on her. However, the stenosis still showed a trend of gradual aggravation. Because the patient did not undergo an enterostomy, the conventional endoscopic magnetic compression technique could not be performed. Hence, we implemented a Y-Z DMR implemented through the anus under single channel. The magnetic ring fell off nine days after the operation and the rectal stenosis was relieved. The patient was followed up for six months and reported good defecation.
The Y-Z DMR deformable magnetic ring is an excellent treatment strategy for patients with rectal stenosis and without enterostomy.
结直肠癌术后吻合口狭窄的治疗通常具有挑战性,特别是对于内镜治疗效果不佳的患者。对于已行肠造口术的患者,狭窄可通过磁压缩轻松解决。然而,普通磁压缩技术无法应用于未行肠造口术的患者。我们设计了一种新型的Y-Z可变形磁环(Y-Z DMR),并成功将其应用于一名直肠癌术后直肠吻合口狭窄且未行肠造口术的患者。
我们在此报告一名57岁女性的病例,她因直肠癌接受了腹腔镜根治性直肠切除术(迪克森术)。然而,术后6个月她开始出现排便困难。结肠镜检查显示直肠吻合口狭窄。对她进行了6次内镜球囊扩张。然而,狭窄仍呈逐渐加重趋势。由于该患者未行肠造口术,无法采用传统的内镜磁压缩技术。因此,我们通过单通道经肛门实施了Y-Z DMR。术后9天磁环脱落,直肠狭窄缓解。对患者进行了6个月的随访,患者报告排便良好。
Y-Z DMR可变形磁环是治疗直肠狭窄且未行肠造口术患者的一种优秀治疗策略。