Clinical Effect Of Endoscopic Treatment Of Gastrointestinal Anastomosis Complications

Objective:To evaluate the safety and effectiveness of endoscopic technique in treating postoperative anastomotic complications of digestive tract.Methods:Clinical data of patients received endoscopic treatment in our hospital due to anastomotic complications after gastrointestinal surgery from January 2015 to December 2018 were collected for retrospective analysis.Endoscopic intervention was used for postoperative anastomotic complications(stenosis,obstruction,leakage or fistula)in all the included cases.The time of the diagnosis of complication,intervention measures,laboratory examination,feeding time after the surgical procedure,endoscopic treatment success rate,incidence of complications,endoscopic intervention times and postoperative follow-up were observed and analyzed.Results:A total of 88 patients were included in the study,including 43 patients with anastomotic stenosis,22 with anastomotic obstruction,23 with anastomotic fistula.For anastomotic obstruction patients,36 patients with anastomosis were successfully treated with endoscopy,other 5 successed with short-term complications and 7failed.For anastomotic obstruction patients,18 cases were successfully treated with endoscopy,and other 4 cases were transferred to surgical treatment.For anastomotic fistula patients,21 cases were successfully treated with endoscopy,other 2 cases were treated with surgery,1 case of rectovaginal fistula was treated with endo-sponge for continuous vacuum aspiration,and 3 cases had short-term postoperative complications.After 3 days of endoscopic treatment,the ratio of postoperative white blood cells and neutrophilic granulocyte percentage levels had no statistically significant differences in each group of anastomosis complications.During follow-up after the endoscopic procedure,4 patients with anastomotic stenosis needed endoscopic intervention again,3 cases undertook surgical intervention and 2 cases maintained acceptable defecation function by intermittent dilation with a plastic dilater.1 of 18 patients with anastomotic obstruction had stent displacement and was removed,endoscopic examination indicated that the anastomosis was normal.For the anastomotic fistula patients,onecase relapsed and then underwent endoscopic intervention again,three cases converted to surgical intervention.Conclusion:Endoscopic treatment of anastomosis complications was effective for some of the patients,especially for those with anastomosis stenosis or stricture,considering its saftey,it might be the first choice for anastomosis complications.