Recanalization of anastomotic occlusion following rectal cancer surgery using a rendezvous endoscopic technique with transillumination: A case report

BACKGROUND Colorectal anastomotic occlusion is a serious complication of colorectal cancer surgery. Although several treatment strategies have been proposed, the management of anastomotic occlusion remains challenging. In this report, we present a case of anastomotic occlusion recanalization performed using a novel technique involving two endoscopes, one for radial incision and the other serving as a guide light. This novel technique offers significant advantages in terms of operational feasibility, reduced invasiveness, rapid recovery, and shortened hospital stay. CASE SUMMARY A 37-year-old man underwent low anterior resection and prophylactic double-lumen ileostomy for rectal cancer in June, 2023. Two months later, complete anastomotic occlusion was observed on colonoscopy. Therefore, we developed a novel atresia recanalization technique. Two endoscopes were placed, one through the colonic anastomosis and the other through the anus. A radial incision was successfully made from the colonic side, guided by the light of the endoscope from the anal side. Atresia recanalization was performed within 20 minutes. Three weeks after recanalization, colonoscopy revealed that the diameter of the colorectal anastomosis was approximately 16 mm and the patient therefore underwent stoma reversal in September. During the follow-up period of approximately one year, the patient remained well and no stenosis or obstruction symptoms were observed. CONCLUSION Endoscopic atresia recanalization of colorectal anastomotic occlusion assisted by an opposing light source is safe and effective.