Treatment of rectal anastomotic atresia with transurethral prostate resection instrumentation: A report of three cases

Hu,Zhentao; Qin,Yujie; Wei,Xiaoyi; Qian,Jun; Tu,Song; Yao,Jiaxi

doi:10.3892/etm.2024.12491

Treatment of rectal anastomotic atresia with transurethral prostate resection instrumentation: A report of three cases

Authors:
- Zhentao Hu
- Yujie Qin
- Xiaoyi Wei
- Jun Qian
- Song Tu
- Jiaxi Yao
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Affiliations: Department of General Surgery II, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China, Department of Endoscopy Center, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China, Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Zhangye, Gansu 734000, P.R. China, Institute of Urology, Hexi University, Zhangye, Gansu 734000, P.R. China
Published online on: March 15, 2024 https://doi.org/10.3892/etm.2024.12491
Article Number: 202
Copyright: © Hu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Dixon surgery for rectal cancer can lead to severe intestinal narrowing and blockage that is difficult to treat with open surgery or colonoscopy. The aim of the present study was to develop a minimally invasive approach for treating rectal anastomotic atresia based on three cases that were managed with transurethral prostate resection instrumentation. Preoperative imaging determined the distance from the anastomotic closure to the anal margin, the length of the anastomotic closure and the degree of proximal intestinal dilation for all cases. During the procedure, the anastomotic site was visualized, and a circular electrode was used to excavate and open the blockage. Membrane‑like closures were directly incised to achieve satisfactory results, with an anastomotic diameter >20 mm. Those cases with tubular atresia required an initial incision using the prostate resectoscope to relieve the obstruction, followed by radial incisions until achieving an anastomotic diameter >20 mm. At 3‑6 months post‑dilation, two of the patients with anastomotic atresia >20 mm had satisfactory bowel movements, whereas the remaining patient experienced tumor recurrence at the anastomotic site and discontinued treatment. This case series demonstrates the potential of transurethral prostate resection instrumentation as a safe and effective minimally invasive approach for rectal anastomotic atresia. Given that prostate resection instrumentation is readily available in hospitals in China, this approach is widely accessible to most patients. Furthermore, the technique leverages existing surgical technology and practices, requiring only a shift in the surgical site.

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