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Late rectal anastomotic leakage treated with diode laser FiLaC probe. A case report of a new minimal invasive treatment

Authors :
Salvatore Tolone
Ludovico Docimo
Luigi Brusciano
Francesco Saverio Lucido
Alessandro Sturiale
Giorgia Gualtieri
Claudio Gambardella
Gianmattia Terracciano
Terracciano, G.
Brusciano, L.
Gualtieri, G.
Gambardella, C.
Sturiale, A.
Lucido, F. S.
Tolone, S.
Docimo, L.
Source :
International Journal of Surgery Case Reports
Publication Year :
2020
Publisher :
Elsevier, 2020.

Abstract

Highlights • Anastomotic leak is a common and potentially dangerous postoperative complication in colo-rectal surgery. • Low anastomotic leak conservative treatment requires five months or more for a complete resolution and a complex management. • The FiLaC laser diode technology could be a good option to reduce the healing time and to minimize patient’s discomfort.<br />Introduction Anastomotic Leakage (AL) is one of the most important early postoperative complication of the adenocarcinoma’s surgical treatment. Fistula Laser Closure (FiLaC®) is a minimal invasive technique that use diode laser energy to obtain the fistula track obliteration and it is finding large application for other affection characterized by fistula tracts presence. Presentation of case A 56 years old male, with no clinical history of adenocarcinoma in his family, underwent a laparoscopic low anterior resection with ileostomy for a rectal adenocarcinoma. Approximately 3 months after the procedure an anastomotic leak with an associated abscess was found. The patient underwent an endoscopic FiLaC off-label procedure on the AL and after further 4 months, he obtained a complete resolution of the anastomosis dehiscence. Discussion The literature is poor about the minimal invasive AL treatment and there is no paper about the management of the AL with the FiLaC® procedure. For asymptomatic patients a conservative solution is preferred, it could be considered a drain positioning for emptying abscesses and for irrigation or the use of an Endosponge to decrease the resolution time. The FiLaC® procedure could be a more feasible technique that could also reduce the healing time as well with no discomfort for the patient. Conclusion Considering the results and our patient healing time, we think that an off-label application of FiLaC® procedure on asymptomatic low anastomotic leak could be an opportunity for a morbidity resolution shorter than the simple wait and see strategy, and more sustainable for the patient.

Details

Language :
English
ISSN :
22102612
Volume :
77
Database :
OpenAIRE
Journal :
International Journal of Surgery Case Reports
Accession number :
edsair.doi.dedup.....c5994006d7a9f9253bb32562039d91ab