Rectal Obstruction after Laparoscopic Low Anterior Resection and Postoperative Treatment That Could Be Treated by Magnet-Compressed Anastomotic Stenosis Restriction Surgery (Second Yamauchi Method)

Abstract

Here, we present the case of a 68-year-old man who underwent laparoscopic low anterior resection for overlap cancer of the sigmoid colon and rectum. After surgery, anastomotic leakage led to peritonitis and abdominal abscess, for which a colostomy was constructed in the transverse colon. Three months after he was discharged with preservative treatment by drainage, complete obstruction of the rectal anastomotic site was confirmed by an enema examination. Tuberculosis was simultaneously detected and treated, and it was decided to attempt the closure of the colostomy and the release obstruction of the intestinal anastomotic part. However, in this case, endoscopic incision or reoperation seemed difficult. Therefore, a magnet-compressed anastomotic stenosis restriction surgery (second Yamauchi method) was performed. After approximately 4 years after this surgery, the opening of the rectal anastomotic site is still maintained. This method is thus considered an effective means for refractory gastrointestinal stricture/obstruction with least medical invasion.