Ji L Q, Zhou J L, Xin C, Li S Y, Wang Y, Lou Z, Zhang W
Department of Anorectal Surgery, Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China.
Department of Anesthesiology, Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2024 Oct 25;27(10):1080-1082. doi: 10.3760/cma.j.cn441530-20231024-00146.
To introduce the method of using anal fistula endoscope to treat chronic sinus tract leakage at rectal anastomosis site. We used anal fistula endoscopy to treat a patient with chronic sinus tract leakage after radical resection of rectal cancer, mainly including the following 5 steps: (1) establishing a water injection circulation system through the anus; (2) scraping off purulent coating and mucosa on the surface of the sinus tract with the brush; (3) hemostasis and removal of necrotic tissue with electrocoagulation rods; (4) filling the sinus tract with bioprotein gel; (5) compressing the sinus tract with transanal drainage tube. The patient is a 70 year old male with rectal cancer. After undergoing 3D laparoscopic assisted radical resection of rectal cancer via abdominal anterior resection (Dixon's procedure) and diverting ileostomy surgery for more than 3 months, leakage of the rectal anastomosis was found through colonoscopy and anal iodine water contrast imaging .The patient started eating and flowing juice 6 hours after surgery, got out of bed 24 hours after surgery, and was discharged 48 hours after the removal of the anal canal. Three months after surgery, colonoscopy and transanal iodine hydrography showed that the sinus repair was intact. The diverting ileostomy was reduced 4 months after surgery. Anal fistula endoscope is safe and feasible for the treatment of chronic sinus tract anastomotic leakage in selected patients.
