Application of endoscopic mucosal advancement in the treatment of chronic anastomotic leakage: A case report

Abstract

Anastomotic leakage is one of the most serious postoperative complications after colorectal surgery. A fistula or chronic sinus formation is one kind of anastomotic leakage. Most fistulas may heal after conservative treatment, but some patients will develop a chronic anastomotic leakage, which definitely requires elective surgery due to the formation of a sinus tract or an internal fistula. This study reports a case of an 88-year-old man with sigmoid colon cancer who developed a chronic anastomotic leakage after colorectal surgery. Endoscopic mucosal advancement combined with titanium clips was successfully performed to close the fistula. The patient was discharged 12 days after the operation and resumed a normal diet 1 week after discharge. Endoscopic mucosal advancement could be an alternative choice for the treatment of chronic anastomotic leakage and can prevent a secondary surgery; however, good bowel preparation and strict inclusion criteria are required.

Keywords

• Endoscopy
• Elderly colon cancer
• Anastomotic leakage
• Titanium clip