A new way to remedy anastomotic leakage after TaTME: A case report

Anastomotic leakage (AL) following low anterior resection remains a serious complication related to mortality and recurrence. We propose a novel method for treating AL after radical resection of low rectal cancer.

The patient was a 36-year-old male who was referred to the department of digestive surgery of our hospital due to intermittent hematochezia for 2 years. Physical examination yielded the following: 9-12 o'clock in the knee-chest (KC) position, about 5 cm from the anal verge, with soft, mobile, unclear edges, and mild tenderness with no blood staining. The patient was pathologically diagnosed as rectal adenocarcinoma before admission and staged as cT3N2M0 by Computed tomography (CT) and magnetic resonance imaging (MRI), long-term radiotherapy (25x45Gy) with chemotherapy(capecitabine), was performed after 4 cycles of CapeOX protocol, and the patient then underwent transanal total mesorectal excision(TaTME). 15 days after the surgery, the patient was readmitted due to hematochezia which caused by AL. We applied modified Bacon operation on this patient, and successfully performed a second operation two weeks later.

Given its simple operation, few complications and effective treatment, Modified Bacon can be used for remedy anastomotic leakage after TaTME.

We propose modified Bacon operation to deal with anastomotic leakage which provides a new strategy to treat AL after low anterior resection (LAR).