The Treatment Efficacy for Patients Undergoing Combined Transanal-Transabdominal Endoscopic Resection of Rectal Anastomosis Stenosis

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2026-09-14 Epub Date: 2026-07-01 DOI:10.1002/jso.70316

Taixuan Wan, Yunxing Shi, Yihang Zhou, Haoqi Zheng, Hao Xie, Fujin Ye, Pinzhu Huang, Maram Alenzi, Zhanzhen Liu, Yonghua Cai, Shuangling Luo, Liang Kang, Liang Huang

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引用次数: 0

Abstract

Background

Combined transanal and transabdominal resection for anastomotic stenosis may provide an opportunity to restore bowel continuity in patients with colorectal anastomotic stenosis. This study aimed to evaluate the therapeutic efficacy of combined transanal-transabdominal resection in patients with rectal anastomotic stenosis.

Methods

We retrospectively analyzed a consecutive cohort of patients who underwent combined transanal-transabdominal endoscopic resection for rectal anastomotic stenosis between August 2019 and March 2023. Data on intraoperative variables, mortality, postoperative complications, and stoma closure were collected. Functional outcomes were evaluated using the Low Anterior Resection Syndrome (LARS) score and the Wexner incontinence score.

Results

A total of 54 patients, including 46 men and 8 women, met the inclusion criteria. In all patients, anastomotic stenosis developed secondary to either anastomotic leakage or preoperative radiotherapy. The median length of hospital stay was 15 days (11–24 days). No postoperative mortality occurred, and the overall morbidity rate was 15%. During a median follow-up of 48 months, stoma closure was achieved in 49 patients after a median interval of 3.8 months (2.5–11 months). At the end of follow-up, stoma closure had failed in 2 patients because of poor anastomotic functional outcomes, and 3 patients developed recurrent anastomotic stenosis. Among the 49 patients available for functional assessment, 35 (71.4%) reported no or minor LARS. The median Wexner incontinence score was 8 (0–18), and 13 patients had a score of 0. Erectile function was evaluated in 28 male patients, of whom 18 reported normal postoperative erectile function.

Conclusions

Combined transanal-transabdominal endoscopic resection appears to be an effective treatment for rectal anastomotic stenosis, with a high rate of stoma closure, low morbidity, and acceptable long-term functional outcomes.

Clinical Trial Registration Number

NCT06036862.

查看原文本刊更多论文

经肛-经腹联合内镜切除直肠吻合口狭窄的疗效观察。

背景：经肛门和经腹部联合切除吻合口狭窄可能为直肠吻合口狭窄患者恢复肠道连续性提供机会。本研究旨在评价经肛-经腹联合切除治疗直肠吻合口狭窄的疗效。方法：我们回顾性分析了2019年8月至2023年3月期间接受经肛-经腹联合内镜切除术治疗直肠吻合口狭窄的连续队列患者。收集术中变量、死亡率、术后并发症和造口闭合的数据。使用前低位切除综合征（LARS）评分和Wexner失禁评分评估功能结局。结果：54例患者符合纳入标准，其中男46例，女8例。在所有患者中，吻合口狭窄继发于吻合口漏或术前放疗。住院时间中位数为15天（11-24天）。术后无死亡发生，总发病率为15%。在中位随访48个月期间，49例患者在中位间隔3.8个月（2.5-11个月）后实现了造口。随访结束时，2例因吻合口功能不佳导致吻合口关闭失败，3例复发性吻合口狭窄。在49例可进行功能评估的患者中，35例（71.4%）报告无或轻微LARS。Wexner失禁评分中位数为8(0-18)，13例患者得分为0。对28例男性患者进行勃起功能评估，其中18例术后勃起功能正常。结论：经鼻-经腹联合内镜切除是治疗直肠吻合口狭窄的有效方法，其吻合口闭合率高，发病率低，远期功能预后可接受。临床试验注册号：NCT06036862。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.