Z Gastroenterol 2013; 51(5): 437-439
DOI: 10.1055/s-0032-1330559
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Behandlung einer postoperativen Rektumstenose mittels eines selbstexpandierenden resorbierbaren Polydioxanon-Stents

Treatment of a Postoperative Rectal Stenosis with a Self-Expanding Biodegradable Polydioxanone Stent
F. Dederichs
1   Klinik für Innere Medizin und Gastroenterologie, Marienhospital Gelsenkirchen
,
S. Knüdeler
1   Klinik für Innere Medizin und Gastroenterologie, Marienhospital Gelsenkirchen
,
W. Nolte
1   Klinik für Innere Medizin und Gastroenterologie, Marienhospital Gelsenkirchen
,
I. Iesalnieks
2   Klinik für Viszeralchirurgie, Marienhospital Gelsenkirchen, Gelsenkirchen, Deutschland
› Author Affiliations
Further Information

Publication History

19 October 2012

03 January 2013

Publication Date:
16 May 2013 (online)

Zusammenfassung

Eine seltene jedoch schwerwiegende Komplikation nach transanaler endoskopischer Mikrochirurgie (TEM) ist die Entwicklung einer Rektumstenose. In einigen Fällen zeigen sich diese benignen Stenosen refraktär bei Behandlung mittels Ballondilatation. Der Einsatz von resorbierbaren Stents mag das Ergebnis in diesen Fällen verbessern, da sie eine Verlängerung der Dilatationsdauer bewirken und nicht entfernt werden müssen. In diesem Fallbericht verwendeten wir einen resorbierbaren Polidioxanon-Stent, der ursprünglich zur Behandlung von gutartigen Ösophagusstenosen entwickelt wurde, zur Behandlung einer refraktären Rektumstenose nach TEM.

Abstract

Rectal stricture is a serious although infrequent complication of transanal endoscopic microsurgery (TEM). In some cases, these strictures may be refractory to treatment by endoscopic balloon dilatation. Biodegradable stents might improve the outcome by providing an extended period of dilatation. Moreover, these stents can remain in place without the need to remove them. In the presented case, a biodegradable polidioxanone stent originally developed to treat benign oesophageal stenoses was used to treat a patient suffering from rectal stricture following a TEM.

 
  • Literatur

  • 1 Barker JA, Hill J. Incidence, treatment and outcome of rectal stenosis following transanal endoscopic microsurgery. Tech Coloproctol 2011; 15 (03) 281-284
  • 2 Scala A, Gravante G, Dastur N et al. Transanal endoscopic microsurgery in small, large, and giant rectal adenomas. Arch Surg 2012; 20: 1-8
  • 3 Rjchrt S et al. Biodegradable stents for the treatment of benign stenoses of the small and large intestines. Endoscopy 2011; 43 (10) 911-917
  • 4 Toth E, Nielsen J, Nemeth A et al. Treatment of a benign colorectal anastomotic stricture with a biodegradable stent. Endoscopy 2011; 43 (Suppl. 02) E252-E253
  • 5 Janik v, Horák L, Hnaniček J et al. Biodegradable polydioxanone stents: a new option for therapy-resistant anastomotic strictures of the colon. Eur Radiol 2011; 21 (09) 1956-1961
  • 6 Belverde B, Frattaroli S, Carbone A et al. Anastomotic strictures in colorektal surgery: treatment with endoscopic balloon dilatation. G Chir 2012; 33 (06) 243-245
  • 7 Araujo SE, Costa AF. Efficacy and safety of endoscopic balloon dilatation of benign anastomotic strictures after oncologic anterior rectal resection: report on 24 cases. Surg Laparosc Endosc Percutan Tech 2008; 18 (06) 565-568
  • 8 Karakan T, Utku G et al. Biodegradable stents for caustic esophageal strictures: a new therapeutic approach. Dis Esophagus 2012; [Epub ahead of print]
  • 9 Vandenplas Y, Hauser B, Devreker T et al. A biodegradable esophageal stent in the treatment of a corrosive esophageal stenosis in a child. J Pediatr Gastroenterol Nutr 2009; 49: 254-257
  • 10 Orive-Calzada A, Alvarez-Rubio M, Romero-Izquierdo S et al. Severe epithelial hyperplasia as a complication of a novelbiodegradable stent. Endoscopy 2009; 41 (Suppl. 02) E137-E138
  • 11 Repici A, Vleggaar FP, Hassan C et al. Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (Biodegradable Esophageal Stent) study. Gastrointest Endosc 2010; 72: 927-934
  • 12 Siersema PD. Stenting for benign esophageal strictures. Endoscopy 2009; 41 (04) 363-373