Minimally Invasive Treatment of a Completely Obstructed Rectal Anastomosis by Using a Transanal Plasmakinetic Resectoscope: a Case Report and Review of Literature

We present a case of successful minimally invasive treatment of a completely obstructed rectal anastomosis by using a transanal plasmakinetic resectoscope, along with a review of the relevant literature. A 75-year-old man underwent low anterior resection for rectal cancer. Complete obstruction of the rectal anastomosis was visualized at 6.0 cm from the anal verge, 5 months later. We carefully cut at the center of the circular staple line to find the orifice of anastomosis with a plasmakinetic resectoscope. Then, a sufficient amount of fibrotic tissue at the stenosis was resected to maintain the continuity of the bowel. At 4 months follow-up, the patient had complete resolution of symptoms. Transanal plasmakinetic resection is a possible choice for treatment of a completely obstructed colorectal anastomosis. However, these techniques have risks and should be implemented with great caution in selected patients by skilled endoscopists or surgeons.