Systemic steroid application for treatment of edematous anastomotic stenosis following delta-shaped anastomosis in laparoscopic distal gastrectomy: a case report

BMC Surg. 2020 Jul 22;20(1):163. doi: 10.1186/s12893-020-00827-3.

Abstract

Background: Delta-shaped anastomosis is a common method of intracorporeal gastroduodenostomy in totally laparoscopic distal gastrectomy. One common postoperative complication of this procedure is anastomotic stenosis, and endoscopic balloon dilatation is a major remedy for such complications. Other treatment strategies are necessary to manage unsuccessful endoscopic balloon dilatation.

Case presentation: We present a case where systemic steroid treatment was applied in sustained anastomotic stenosis after endoscopic balloon dilatation. We performed delta-shaped anastomosis in laparoscopic distal gastrectomy to treat early-stage gastric cancer in a patient. The patient experienced abdominal pain post-surgery; subsequent investigation revealed edematous anastomotic stenosis. The stenosis sustained even after endoscopic balloon dilatation and local steroid injection. Consequently, we applied systemic steroid treatment.

Conclusion: Systemic steroid treatment improved the stenosis and no recurrence was observed. These results suggest that systemic steroid application could be useful to treat anastomotic stenosis.

Keywords: Anastomotic stenosis; Delta-shaped anastomosis; Gastrectomy; Gastric cancer; Steroid.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Constriction, Pathologic / drug therapy
  • Constriction, Pathologic / etiology*
  • Dilatation / methods
  • Edema / drug therapy
  • Edema / etiology
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Gastroenterostomy / adverse effects*
  • Gastroenterostomy / methods
  • Glucocorticoids / administration & dosage*
  • Humans
  • Laparoscopy
  • Male
  • Neoplasm Recurrence, Local
  • Prednisolone / administration & dosage*
  • Retrospective Studies
  • Stomach Neoplasms* / surgery

Substances

  • Glucocorticoids
  • Prednisolone