Treatment of Complete Anastomotic Obstruction after Laparoscopic Sigmoidectomy with Magnet-compressed Anastmotic Stenosis Restriction Surgery—Report of a Case—

Abstract

A loop colostomy was created in the transverse colon in a 66-year-old man with locally advanced sigmoid colon cancer and obstructive colitis. The patient underwent neoadjuvant chemotherapy (FOLFOXIRI+bevacizumab therapy), laparoscopic sigmoidectomy and colostomy. As the colostomy was not closed, adjuvant chemotherapy (mFOLFOX6 therapy) was performed. Five months after sigmoidectomy, complete occlusion of the anastomosis was confirmed via barium enema, before colostomy closure. Surgical resection of the anastomotic site and high-frequency incision using an endoscopic laser were considered. However, magnetic compression anastomotic stenosis release (second Yamauchi method), which is the least invasive method, was performed. After confirming the anal exit of the magnets and endoscopically verifying good patency of the anastomotic site, colostomy closure was performed on the fifth day. Defecation after the procedure was good. One year later, additional dilation was not required, and the anastomosis remained patent.

This method can be an effective and minimally invasive treatment option for the complete occlusion of an anastomosis after lower gastrointestinal surgery.