Endoscopic submucosal dissection of a rectal lesion recurrence at the anastomotic site: when the staples lead the way

Abstract Text We present a case of a neoplastic recurrence over an anastomosis site which was treated by endoscopic submucosal dissection. Submucosal injection showed non-lifting sign in the lesion area over the surgical anastomosis. After dissection of the submucosa without fibrosis, an extensive 2cm surgical staple line was reached. At this point, the ESD was technically challenging not only due to the presence of the staples which often hindered electric current passage, but also due to the severe associated fibrosis. During the dissection, two adjacent 2mm microperfurations were noted, which were effectively closed with two over-the-scope clips. An R0 en bloc resection of a tubular adenoma with low and high grade dysplasia was achieved [1] [2].

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• 1 Hellinger MD, Santiago CA.. Reoperation for recurrent colorectal cancer. Clin Colon Rectal Surg 2006; 19: 228-236
• 2 Krutsri C, Toyonaga T, Ishida T. et al. Feasibility of endoscopic submucosal dissection of lesions at anastomosis site post-colorectal surgery: a case series. Endosc Int Open 2019; 07: E949-954

Publication History

Article published online:
14 April 2023