EUS-guided recovery of colonic continuity after complete anastomotic stenosis with a nitinol self-expanding stent

Е Г Солоницын ,Ш У Киреев ,И Н Данилов ,А А Ковалёв

doi:10.31146/1682-8658-ecg-179-7-163-166

Е Г Солоницын , Ш У Киреев + Show 2 more

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https://doi.org/10.31146/1682-8658-ecg-179-7-163-166

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Abstract

Recovery of intestinal continuity is remaining a complex issue in abdominal surgery. Previous operations, such as Hartmann's procedure, are usually done in the emergent setting, often in frail and septic patients. As a result, severe adhesions occur, and recognition of various anatomical structures becomes more difficult.The article describes a clinical case of EUS-guided recovery of rectum's continuity after complete anastomotic stenosis. The operation “EUS-guided formation of rectosigmoid anastomosis using Lumen-Apposing Metal Stent” was performed.In order to obtain a stable anastomosis within 6 months, a session of bougienage and 4 sessions of balloon dilatation were performed. Currently, the diameter of the colon at the stricture level is about 14 mm, clinically stricture is not significant.EUS-guided enterostomy can be used to form an intestinal anastomosis in patients with benign diseases. However, this method alone is not the final method of treatment and requires further supervision of patients.

Highlights

In order to obtain a stable anastomosis within 6 months, a session of bougienage and 4 sessions of balloon dilatation were performed
EUS-guided enterostomy can be used to form an intestinal anastomosis in patients with benign diseases
Рисунок 2: (а) Пункция просвета прямой кишки под EUS-наведением; (б) Установленный саморасправляющийся нитиноловый стент

Summary

Recovery of intestinal continuity is remaining a complex issue in abdominal surgery. Previous operations, such as Hartmann’s procedure, are usually done in the emergent setting, often in frail and septic patients. EUS-guided enterostomy can be used to form an intestinal anastomosis in patients with benign diseases. This method alone is not the final method of treatment and requires further supervision of patients. Все это в значительной степени усложняет отсроченные реконструктивные вмешательства, увеличивает их продолжительность, требует большого опыта хирургической бригады. Возникающих у 2–22% пациентов данной группы, являются стриктуры межкишечных анастомозов [2]. Перспективным методом лечения данных стриктур являются интервенционные вмешательства под ЭУС-навигацией. Не определена дальнейшая тактика ведения таких пациентов с целью сохранения адекватного диаметра сформированного соустья

Клинический случай

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