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CASE REPORT article

Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1425822
This article is part of the Research Topic Advances in Proctology and Colorectal Surgery Volume II View all 4 articles

Resolution of occult anastomotic stricture with anal dilator: Challenges with the conventional diagnostic criteria in low anterior rectal resection patient-A case report

Provisionally accepted
Gaoyang Cao Gaoyang Cao 1Xinjie Zhang Xinjie Zhang 1*Songtao Wu Songtao Wu 2Wei Zhou Wei Zhou 1*
  • 1 Department of Colorectal surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
  • 2 School of Medicine, Zhejiang University, Hangzhou, China

The final, formatted version of the article will be published soon.

    Background: Anastomotic stricture (AS) is a common complication following rectal cancer surgery with anastomosis, but its diagnosis and management pose significant challenges due to the lack of standardized diagnostic criteria. We present a case highlighting the complexities encountered in diagnosing and managing occult AS postrectal cancer surgery. Case Presentation: A 51-year-old male, post-robot-assisted laparoscopic low anterior resection for rectal adenocarcinoma, presented with symptoms suggestive of AS. Despite conventional evaluations, including colonoscopy, digital rectal examination and radiography, AS was not identified. Following prolonged and ineffective treatment for suspected conditions such as Low Anterior Resection Syndrome (LARS), the patient underwent anal dilatation, resulting in significant symptom improvement. Conclusion: This case underscores the challenges associated with diagnosing and managing occult AS following rectal cancer surgery. The absence of standardized diagnostic criteria and reliance on conventional modalities may lead to underdiagnosis and inadequate treatment. A comprehensive diagnostic approach considering intestinal diameter, elasticity, and symptoms related to difficult defecation may enhance diagnostic accuracy. Further research is needed to refine diagnostic and therapeutic strategies for occult AS.

    Keywords: Anastomotic stricture, Occult, Rectal cancer surgery, Anal dilatation, diagnostic criteria

    Received: 15 May 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Cao, Zhang, Wu and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xinjie Zhang, Department of Colorectal surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
    Wei Zhou, Department of Colorectal surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China

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