Cao Gaoyang, Zhang Xinjie, Wu Songtao, Zhou Wei
Department of Colorectal Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
School of Medicine, Zhejiang University, Hangzhou, China.
Front Oncol. 2024 Aug 7;14:1425822. doi: 10.3389/fonc.2024.1425822. eCollection 2024.
Anastomotic stricture (AS) is a common complication following rectal cancer surgery with anastomosis, but its diagnosis and management pose significant challenges due to the lack of standardized diagnostic criteria. We present a case highlighting the complexities encountered in diagnosing and managing occult AS post-rectal cancer surgery.
A 51-year-old male patient presented with symptoms suggestive of AS following robot-assisted laparoscopic low anterior resection for rectal adenocarcinoma. Despite conventional evaluations, including colonoscopy, digital rectal examination, and radiography, AS was not identified. Following prolonged and ineffective treatment for suspected conditions such as low anterior resection syndrome (LARS), the patient underwent anal dilatation, resulting in significant symptom improvement.
This case underscores the challenges associated with diagnosing and managing occult AS following rectal cancer surgery. The absence of standardized diagnostic criteria and reliance on conventional modalities may lead to underdiagnosis and inadequate treatment. A comprehensive diagnostic approach considering intestinal diameter, elasticity, and symptoms related to difficult defecation may enhance diagnostic accuracy. Further research is needed to refine the diagnostic and therapeutic strategies for occult AS.
吻合口狭窄（AS）是直肠癌吻合术后常见的并发症，但由于缺乏标准化的诊断标准，其诊断和处理面临重大挑战。我们报告一例病例，突出显示了直肠癌术后隐匿性AS诊断和处理中遇到的复杂性。
一名51岁男性患者在接受机器人辅助腹腔镜低位前切除术后出现提示AS的症状，该手术用于治疗直肠腺癌。尽管进行了包括结肠镜检查、直肠指检和影像学检查在内的常规评估，但未发现AS。在对疑似低位前切除综合征（LARS）等病症进行长期且无效的治疗后，患者接受了扩肛治疗，症状得到显著改善。
该病例强调了直肠癌术后隐匿性AS诊断和处理的挑战。缺乏标准化诊断标准以及对传统检查方法的依赖可能导致漏诊和治疗不足。综合考虑肠管直径、弹性以及与排便困难相关症状的诊断方法可能会提高诊断准确性。需要进一步研究以完善隐匿性AS的诊断和治疗策略。
