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Marsupialization of presacral collections with use of an endoscopic stapler
1University Department of Surgery, Royal Brisbane Hospital, Australia.
Abstract:
Patients with anastomoses at the anorectal ring, with or without anastomotic dehiscence, may develop large presacral collections. Such collections often drain poorly through the anastomosis, leading to chronic sepsis. A novel method of widely draining such collections by "marsupialization" into the bowel lumen with use of an endoscopic stapler inserted transanally is described.
Insights
Large presacral collections can form after anorectal surgery, leading to chronic sepsis due to poor drainage. A new endoscopic stapler technique, "marsupialization," offers effective transanal drainage for these challenging collections.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Anastomoses at the anorectal ring can lead to large presacral collections.
- These collections often exhibit poor spontaneous drainage into the bowel lumen.
- Inadequate drainage can result in persistent sepsis and complications.
Purpose of the Study:
- To describe a novel transanal endoscopic technique for draining large presacral collections.
- To present a method for marsupialization of presacral collections into the bowel lumen.
- To offer a solution for managing chronic sepsis secondary to poorly drained anastomotic complications.
Main Methods:
- A transanal endoscopic approach was utilized.
- An endoscopic stapler was employed to create a marsupialization.
- The technique facilitates wide drainage of presacral collections into the rectal lumen.
Main Results:
- The described marsupialization technique allows for effective and wide drainage.
- This method addresses the challenge of poor drainage from presacral collections.
- Potential for reducing chronic sepsis associated with these collections.
Conclusions:
- Transanal marsupialization using an endoscopic stapler is a viable novel method.
- This technique provides an effective means to drain presacral collections.
- It offers a promising approach for managing patients with anorectal anastomotic complications and sepsis.