Y–Z deformable magnetic ring for the treatment of rectal stricture: A case report and review of literature

BACKGROUND Treatment of postoperative anastomotic stenosis for colorectal cancer is often challenging,especially for patients who do not respond well to endoscopy.In cases where patients have undergone an enterostomy,the stenosis can be easily resolved through magnetic compression.However,common magnetic compre-ssion techniques cannot be performed on those without enterostomy.We design-ed a novel Y–Z deformable magnetic ring(Y–Z DMR)and successfully applied it to a patient with a stenosis rectal anastomosis and without enterostomy after rectal cancer surgery.CASE SUMMARY We here report the case of a 57-year-old woman who had undergone a laparo-scopic radical rectum resection(Dixon)for rectal cancer.However,she started facing difficulty in defecation 6 months after surgery.Her colonoscopy indicated stenosis of the rectal anastomosis.Endoscopic balloon dilation was performed six times on her.However,the stenosis still showed a trend of gradual aggravation.Because the patient did not undergo an enterostomy,the conventional endoscopic magnetic compression technique could not be performed.Hence,we imple-mented a Y–Z DMR implemented through the anus under single channel.The magnetic ring fell off nine days after the operation and the rectal stenosis was relieved.The patient was followed up for six months and reported good defeca-tion.CONCLUSION The Y–Z DMR deformable magnetic ring is an excellent treatment strategy for patients with rectal stenosis and without enterostomy.

Treatment of anastomotic stricture after rectal cancer operation by magnetic compression technique:A case report

BACKGROUNDThe treatment of postoperative anastomotic stenosis(AS)after resection of colorectalcancer is challenging.Endoscopic balloon dilation is used to treat stenosisin such cases,but some patients do not show improvement even after multipleballoon dilations.Magnetic compression technique(MCT)has been used for gastrointestinalanastomosis,but its use for the treatment of postoperative AS aftercolorectal cancer surgery has rarely been reported.CASE SUMMARYWe report a 72-year-old man who underwent radical resection of colorectal cancerand ileostomy one year ago.An ileostomy closure was prepared six months ago,but colonoscopy revealed a narrowing of the rectal anastomosis.Endoscopic balloondilation was performed three times,but colonoscopy showed no significantimprovement in stenosis.The AS was successfully treated using MCT.CONCLUSIONMCT is a minimally invasive method that can be used for the treatment of postoperativeAS after colorectal cancer surgery.

Clinical study of extrahepatic biliary adenoma

BACKGROUND Biliary adenomas that occur in the extrahepatic biliary tree are rare.It is difficult to distinguish it from cholangiocarcinoma or cholangiolithiasis by various imaging examinations,and it is very easy to be misdiagnosed.AIM To evaluate the cumulative experiences including clinical characteristics and treatments of nine patients diagnosed with extrahepatic biliary adenoma admitted to the First Affiliated Hospital of Xi’an Jiaotong University from 2016 to 2022.METHODS A total of nine patients were included in our study.The laboratory examinations,disease diagnosis,therapy and pathological characteristics,and follow-up of every patient were evaluated.RESULTS Our cohort consisted of six females and three males with an average diagnosis age of 65.1 years(range 46-87).Six extrahepatic biliary adenomas were located in the common bile ducts and three in the hepatic duct.On initial presentation,all of the patients have symptom of biliary origin,including obstructive jaundice(4/9,44.4%),abdominal pain(6/9,66.7%),and fever(3/9,33.3%).Preoperative imaging examination considered bile duct carcinoma in 6 cases and bile duct calculi in 3 cases.All the patients received surgical treatment and were confirmed by pathology as biliary adenoma.The symptoms improved significantly in all 9 patients after surgery.Seven of nine patients recovered well at follow-up without tumor recurrence.One patient died 2 mo after the surgery due to heart failure.One patient developed jaundice again 8 mo after surgery,underwent endoscopic retrograde cholangiopancreatography and biliary stent placement.CONCLUSION Benign extrahepatic biliary tumors are rare and difficult to diagnosis preoperatively.Intraoperative choledochoscopy and timely biopsy may offer great advantages.