Sutureless large bowel anastomosis: European experience with the biofragmentable anastomosis ring

Abstract

Sutureless colonic anastomosis using a biofragmentable anastomosis ring (BAR) has been evaluated in a prospective randomized comparison with sutures and staples for elective colorectal surgery. One hundred and one patients underwent BAR anastomosis, 85 a sutured anastomosis, and 16 a stapled anastomosis. There were two anastomotic leaks in the patients undergoing BAR anastomosis, seven in patients having a sutured anastomosis, and one in a patient who had a stapled anastomosis. Wound infection occurred in ten BAR patients, ten sutured patients and no stapled patient. There was no statistically significant difference in these or in other postoperative complications between the groups. The BAR was easy to use and is a safe alternative to sutures and staples for large bowel anastomosis.

Systematic Review of the Technique of Colorectal Anastomosis

“…141 Today the biofragmentable anastomotic ring, made of absorbable polyglycolic acid, is used most often. Four included experimental studies [107][108][109][110] showed that compression colorectal anastomosis leads to acceptable healing and strength; 6 included RCTs [111][112][113][114][115][116] provide equivalent conclusions, finding no significant differences between hand-sewn and compression colorectal anastomosis. Also, noncomparative clinical cohort studies [142][143][144][145] including up to 1360 patients have reported incidences of AL between 0.7% and 5%.…”

Efficacy of NiTi Hand CAC™ 30 for jejunojejunostomy in gastric cancer surgery: results from a multicenter prospective randomized trial

“…Findings from other clinical studies in which a compressive anastomotic device was used for lower gastrointestinal surgery showed advantages in terms of overall operation time, postoperative complications, and recovery of bowel function, as well as anastomotic time [16,22,23]. Jejunojejunostomy in total gastrectomy for the treatment of gastric cancer is basically a small part of the entire operation.…”

Estudo comparativo de anastomoses colorretais com anel biofragmentável e com grampeador em cães submetidos à irradiação gama pré-operatória

“…A semelhança no resultado das anastomoses do intestino grosso realizadas com anel biofragmentável, com grampeador e com sutura manual tem sido evidenciada em estudos experimentais 11,13,37 e clínicos 13,[38][39][40] . Existem algumas vantagens do anel biofragmentável em relação aos outros métodos, como ausên-cia de corpos estranhos nas anastomoses, possibilidade de utilização em qualquer ponto do intestino dentro da cavidade abdominal e representação de técnica padronizada 40 .…”