A case of late suture failure after low anterior resection for rectal cancer

A man in his 68 underwent low anterior resection for Ra rectal cancer with multiple hepatic metastases. His postoperative course was uneventful, and modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) treatment for the hepatic metastases was initiated in the first month after the operation...

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Bibliographic Details
Published inNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 72; no. 12; pp. 3108 - 3112
Main Authors KOMINAMI, Hiroaki, KAWASAKI, Kentaro, TANAKA, Kenichi, FUJITA, Toshitada, FUJINO, Yasuhiro, TOMINAGA, Masahiro
Format Journal Article
LanguageEnglish
Japanese
Published Japan Surgical Association 2011
Subjects
concervative treatment
late anastomotic leakage
rectal cancer
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Summary:A man in his 68 underwent low anterior resection for Ra rectal cancer with multiple hepatic metastases. His postoperative course was uneventful, and modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) treatment for the hepatic metastases was initiated in the first month after the operation. Abdominal computed tomography for the evaluation of the treatment effect at the end of 3 courses of chemotherapy revealed air bubbles produced in succession from the anastomotic site within a soft-tissue shadow in the presacral region. Fluoroscopic and endoscopic examinations of the lower gastrointestinal tract revealed fistula formation on the anastomotic suture line of the rectum, which led to a diagnosis of late suture failure. Because the patient abstained from food and received central venous nutrition therapy for a week, the fistula closed, and the air bubbles disappeared. Chemotherapy was restarted after a one-month washout period.
ISSN:1345-2843
1882-5133
DOI:10.3919/jjsa.72.3108