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Colon Stricture After Ischemia Following a Robot-Assisted Ultra-Low Anterior Resection With Coloanal Anastomosis

대한대장항문학회지 2015년 31권 4호 p.157 ~ 162
 ( Lim Dae-Ro ) - Yonsei University College of Medicine Department of Surgery

 ( Hur Hyuk ) - Yonsei University College of Medicine Department of Surgery
 ( Min Byung-Soh ) - Yonsei University College of Medicine Department of Surgery
 ( Baik Seung-Hyuk ) - Yonsei University College of Medicine Department of Surgery
 ( Kim Nam-Kyu ) - Yonsei University College of Medicine Department of Surgery

Abstract


Four consecutive cases of a colonic stricture following a da Vinci robot-assisted ultra-low anterior resection (LAR) with coloanal anastomosis and diverting ileostomy for the treatment of rectal cancer are reported. The colonic strictures developed after early proximal colonic ischemia without anastomotic site leakage or disruption. All patients were treated with preoperative chemoradiation therapy. During the postoperative recovery period, patients developed colonic ischemia, presenting with a high, spiking fever, but without any symptoms of peritonitis. Patients were treated with conservative management (antibiotic therapy) and discharged after two weeks when in good condition. Several months after discharge, all four patients developed a long-segment colonic stricture from the anastomosis site to the distal colon. Management of the colon strictures, including the anastomotic site, involved colonic dilation with a Hegar dilator in an outpatient clinic for several months. The ileostomies in three patients could not be closed.

키워드

Colonic stricture; Colonic ischemia; Coloanal anastomosis surgery
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