Systemic steroid application for treatment of edematous anastomotic stenosis following delta-shaped anastomosis in laparoscopic distal gastrectomy: a case report

Abstract Background Delta-shaped anastomosis is a common method of intracorporeal gastroduodenostomy in totally laparoscopic distal gastrectomy. One common postoperative complication of this procedure is anastomotic stenosis, and endoscopic balloon dilatation is a major remedy for such complications...

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Bibliographic Details
Main Authors: Jun Arima, Kohei Taniguchi, Toshihiro Kobayashi, Ichiro Tsunematsu, Shuji Kagota, Junna Sakane, Yusuke Suzuki, Kazuhisa Uchiyama, Masako Hiramatsu
Format: Article
Language:English
Published: BMC 2020-07-01
Series:BMC Surgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12893-020-00827-3
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Summary:Abstract Background Delta-shaped anastomosis is a common method of intracorporeal gastroduodenostomy in totally laparoscopic distal gastrectomy. One common postoperative complication of this procedure is anastomotic stenosis, and endoscopic balloon dilatation is a major remedy for such complications. Other treatment strategies are necessary to manage unsuccessful endoscopic balloon dilatation. Case presentation We present a case where systemic steroid treatment was applied in sustained anastomotic stenosis after endoscopic balloon dilatation. We performed delta-shaped anastomosis in laparoscopic distal gastrectomy to treat early-stage gastric cancer in a patient. The patient experienced abdominal pain post-surgery; subsequent investigation revealed edematous anastomotic stenosis. The stenosis sustained even after endoscopic balloon dilatation and local steroid injection. Consequently, we applied systemic steroid treatment. Conclusion Systemic steroid treatment improved the stenosis and no recurrence was observed. These results suggest that systemic steroid application could be useful to treat anastomotic stenosis.
ISSN:1471-2482