Acupotomy in the management of colostomy stenosis after abdominoperineal resection: a case report.

Stomal stenosis is a well-recognized complication of permanent colostomy following abdominoperineal resection (APR) for rectal cancer, occurring in approximately 2%-15% of patients. Conservative management is the first-line treatment. When conservative treatment fails, surgery is often required, which increases patient discomfort, offers limited therapeutic benefit, and incurs higher costs. We report the use of acupotomy to treat stomal stenosis in a 55-year-old female patient after APR for rectal cancer. Two months postoperatively, the patient developed stomal stenosis. After excluding tumor recurrence, severe infection, and parastomal hernia, acupotomy was performed. Following stoma and peristomal skin disinfection, local infiltration anesthesia with lidocaine was administered. Using the little finger into the stoma as a guide, fibrotic scar tissue at the stenotic ring was carefully released along the bowel wall with an acupotomy knife until the stoma could accommodate an index finger. The stenosis was resolved immediately, and the patient's symptoms were promptly relieved. Acupotomy may be a feasible, minimally invasive option based on this single case, but the evidence level is limited.