Successful Use of Self-expandable Metallic Stent in a Patient with Anastomotic Stenosis.

Accession number;03A0146673
Title;Successful Use of Self-expandable Metallic Stent in a Patient with Anastomotic Stenosis.
Author;SAIDA YOSHIHISA(Toho Univ., Sch. of Med.)   SUMIYAMA YOSHINOBU(Toho Univ., Sch. of Med.)   NAGAO JIRO(Toho Univ., Sch. of Med.)   TAKASE MAKOTO(Toho Univ., Sch. of Med.)   OKUMURA CHIDORI(Toho Univ., Sch. of Med.)   NAKAMURA YOICHI(Toho Univ., Sch. of Med.)   NAKAMURA YASUSHI(Toho Univ., Sch. of Med.)   URAMATSU MASASHI(Toho Univ., Sch. of Med.)   KATAGIRI MIWA(Toho Univ., Sch. of Med.)   
Journal Title;Gastroenterol Endosc
Journal Code:G0608B
ISSN:0387-1207
VOL.45;NO.2;PAGE.168-171(2003)
Figure&Table&Reference;FIG.4, REF.19
Pub. Country;Japan
Language;Japanese
Abstract;This is a report of utilizing self-expandable metallic stent (EMS) for releasing benign obstruction caused by anastomotic torsion at colostomy closure. A 74-year-old male was detected to have a 5 mm flat polyp in the Rb region in September 2000, which was diagnosed as a recurrent tumor of sm2, having undergone polypectomy previously. In October 2000, low anterior resection was performed and covering loop colostomy was constructed at the descending colon. On February 22, 2001, the colostomy was closed. On the postoperative 11th day, ileus was observed and Gastrografin (amidotrizoic acid) enema demonstrated a stenosis at the anastomosis. where a contrast agent did not pass but colonoscope easily went through. So, the ileus was defined as a bend at the proximal side of the anastomosis and torsion. As the condition was not improved with conservative treatment, colonoscopy and introduction of EMS (Ultraflex, 8 mm in diameter and 80 mm in length; Boston Science Co, Ltd.) under fluoroscopic guidance were performed on the postoperative 21st day. Soon after EMS insertion, flatus and watery diarrhea were observed, and flatulence was diminished. Mild tenderness around EMS site and fever were observed on the next day, but they disappeared a day after. The patient presented a good prognosis and was discharged on the 10th day after EMS introduction. In the 4th month after discharge, EMS fell off without patient's recognition. Neither ileus nor recurrent cancer has been observed for a year. EMS insertion for the large intestine is feasible not only for malignant stenosis but also for benign stenosis, in some cases, providing carlier improvement of QOL. (author abst.)