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DOI: 10.1055/a-2304-8401
Endoscopic suture-based closure of a dehiscent rectal stump
Authors
Lower anterior rectal resection (LAR) with discontinuity resection is performed to avoid leakage of the colorectal anastomosis in high risk patients [1]. Unfortunately, rectal stump leakage can occur, and reoperation is associated with high morbidity and mortality. Endoscopic techniques, such as rinsing or vacuum-based therapy, have shown promising results in rectal leak management [2]. Recently, various endoscopic suture-based techniques have been introduced to facilitate gastrointestinal defect closure and leak or fistula management [3]. We describe the case of a 66-year-old man with rectal stump leakage, presenting to our unit 12 days after LAR and discontinuity resection. We opted for a two-step approach with initial suturing of the large post-surgical defect using the through-the-scope X-Tack Endoscopic HeliX Tacking System (Apollo Endosurgery, Austin, Texas, USA) ([Video 1]).
Endoscopic tack-and-suture technique for closure of a rectal stump dehiscence with a through-the-scope suturing device.Video 1Endoscopy_UCTN_Code_TTT_1AQ_2AK
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Publikationsverlauf
Artikel online veröffentlicht:
29. April 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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References
- 1 Ritter AS, Dumm N, Deisenhofer JM. et al. Risk factors for rectal stump leakage after discontinuity resection: stump length matters most. Dis Colon Rectum 2024; 67: 138-150
- 2 Kühn F, Zimmermann J, Beger N. et al. Endoscopic vacuum therapy for treatment of rectal stump leakage. Surg Endosc 2021; 35: 1749-1754
- 3 Canakis A, Dawod SM, Dawod E. et al. Efficacy, feasibility, and safety of the X-Tack Endoscopic HeliX Tacking System: a multicenter experience. J Clin Gastroenterol 2024;