Application of a linear stapler to the laparoscopic treatment of gastrocolic fistula in patients with Crohn’s disease

• Published in: Techniques in coloproctology Vol. 22; no. 12; pp. 981 - 984
• Main Authors: Nagai, S., Nagayoshi, K., Sadakari, Y., Fujita, H., Ohuchida, K., Ohtsuka, T., Nakamura, M.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2018; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Colonic Diseases - etiology; Colonic Diseases - surgery; Colorectal Surgery; Crohn Disease - complications; Crohns disease; Fistula; Gastric Fistula - etiology; Gastric Fistula - surgery; Gastroenterology; Humans; Intestinal Fistula - etiology; Intestinal Fistula - surgery; Laparoscopy; Laparoscopy - instrumentation; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Proctology; Surgery; Surgical Staplers; Trick of the Trade; Intra-abdominal Fistulas; Ileocolic Fistula; Linear Stapler; Gastrocolic Fistula; Laparoscopic Treatment
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-018-1903-1

Crohn’s disease (CD) is a chronic bowel disease character- ized by inflammation of the gastrointestinal tract. All seg- ments of the gastrointestinal tract can be affected, leading to complications such as strictures, abscesses, or fistulas. Although internal fistulas occur in approximately 20–35% of patients with CD, gastrocolic fistulas are very rare [1]. Despite improvement in medical therapy for patients with CD, such as treatment with steroids, azathioprine, and anti- tumor necrosis factor-α agents, patients with gastrocolic fistulas nearly always require surgical treatment. Minimally invasive surgery for inflammatory disease was recently shown to be safe and effective. We have also reported the feasibility of laparoscopic surgery for CD [2]. However, lap- aroscopic surgery for CD often results in conversion to open laparotomy. The conversion rate of laparoscopic surgery in patients with CD reportedly ranges from 8.5 to 13.4% [3]. One reason for conversion is the difficulty of treating such fistulas. In this article, we describe a simple and efficient tech- nique for the treatment of gastrocolic fistula in patients with CD using a linear stapler during laparoscopic surgery.