Radial incision and cutting method using a transanal approach for treatment of anastomotic strictures following rectal cancer surgery: a case report

Pramod Nepal,
Shinichiro MoriEmail author,
Yoshiaki Kita,
Kan Tanabe,
Kenji Baba,
Yasuto Uchikado,
Hiroshi Kurahara,
Takaaki Arigami,
Masahiko Sakoda,
Kosei Maemura and
Shoji Natsugoe

World Journal of Surgical Oncology201917:48

https://doi.org/10.1186/s12957-019-1592-x

Received: 6 November 2018
Accepted: 7 March 2019
Published: 14 March 2019

Abstract

Background

Development of an anastomotic stricture following rectal cancer surgery is not uncommon. Such strictures are usually managed by manual or instrumental dilatation techniques that are often insufficiently effective, as evidenced by the high recurrence rate. Various surgical procedures using minimally invasive approaches have also been reported. One of these procedures, endoscopic radial incision and cutting (RIC), has been extensively reported. However, RIC by transanal minimally invasive surgery (TAMIS) is yet to be reported. We here report a novel application of TAMIS for performing RIC for anastomotic rectal stenosis.

Case presentation

A 67-year-old man had suffered from constipation for 6 years after undergoing low anterior resection for stage II rectal cancer 7 years ago. Colonoscopy showed a 1-cm diameter stricture in the lower rectum. Balloon dilatation was performed many times because of repeated recurrences. Thus, surgical management was considered and the stricture was successfully excised via a RIC method using a TAMIS approach. Postoperatively, the patient had minimal leakage that resolved with conservative treatment.