Stapled revision of complete colorectal anastomotic obstruction

Colonic and rectal anastomotic strictures occur with an incidence ranging from 3% to 30%. Several factors, such as defunctionalization, anastomotic leak, ischemia, radiation, and neoplasms, have been implicated in their pathogenesis. Management of large bowel strictures is generally based on their cause, location, and appearance. Various methods have been described, including endoscopic techniques (eg, balloon dilatation and/or stents) and operative revision. Postoperative rectal strictures usually respond well to direct dilatation, without the need for endoscopic balloons. If surgical revision is necessary, morbidity can be significant, as in any reoperative procedure. We hereby present a novel surgical method of revision for a complete anastomotic obstruction, which proved effective and avoided extensive operative dissection, mobilization, and re-resection.