Biofragmentable Anastomosis Ring Versus Stapled Anastomoses in the Extraperitoneal Rectum: Experimental Study in Dogs

Czeczko, Nicolau Gregori; Polonio, Benur; Colaço, Luísa; Simões, João Costa; Dietz, Ulrich

doi:10.1007/978-3-642-79260-1_3

Cited by 2 publications

(4 citation statements)

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“…Even steroid application has no negative influence on the healing process of BAR anastomoses in dogs [15]. Experimental studies clearly showed good results using the BAR in irradiated regions [16,17] and in the extraperitoneal rectum [18]. Some limitations remain.…”

Section: Discussionmentioning

confidence: 99%

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Overview on Compression Anastomoses: Biofragmentable Anastomosis Ring Multicenter Prospective Trial of 1666 Anastomoses

et al. 1998

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This study represents a European prospective clinical multicenter trial and was undertaken to evaluate the applicability of the biofragmentable anastomosis ring (BAR) as a routine anastomotic tool in teaching hospitals. The trial results analyzed consisted of 1666 BAR anastomoses performed in 1360 patients from March 1989 to May 1996 in the upper (1042 anastomoses) and lower (624 anastomoses) gastrointestinal (GI) tract. Only patients selected for elective procedures and having previously undergone orthograde bowel cleansing were entered into the trial. In the upper GI tract six anastomoses (0.58%) developed clinically relevant and radiologically detectable leaks with indications for reoperation. In the lower GI tract 42 (6.73%) anastomoses showed a radiologically detectable leak with clinical manifestations in 28 cases (4.48%). Reoperation was performed in 18 cases (2.80%). The overall leakage rate with clinical relevance was 2.04%. Three gastrojejunostomy episodes of bleeding were observed (0.18%) at the BAR anastomotic site. During the early postoperative course there was no ileus due to obstruction of a BAR anastomosis. Reintroduction of diet after the operation was not delayed. In two centers a follow-up evaluation reported no BAR-related late anastomotic stenoses. There were no intraoperative deaths, but 54 patients died postoperatively. Peritonitis following anastomotic leakage was responsible for postoperative deaths in four cases; three of them were related to BAR anastomoses. In conclusion, the BAR anastomotic procedure is an established, rapid, simple to learn, highly standardized, safe technique with the advantage of no persistent foreign material in the anastomotic region and therefore no induction of stenosis. At present, the application of anastomoses in various segments of the GI tract, from the stomach to the middle third of the rectum, can be recommended.

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Section: Discussionmentioning

confidence: 99%

“…There was no ileus due to obstruction of a BAR anastomosis. However, we advise a low fiber diet until the ring fragments have been evacuated from the bowel (postoperative days [15][16][17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Overview on Compression Anastomoses: Biofragmentable Anastomosis Ring Multicenter Prospective Trial of 1666 Anastomoses

et al. 1998

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“…Der auf Abb. 2 sichtbare Anastomosenwulst deutet darauf hin, dass bei der BAR-Anastomose der Heilungsverlauf über eine nicht-ischämisierende Kompression erfolgt, und dieser Wulst sich im Verlauf -wie bei anderen Studien mit späteren Nachuntersuchungen auch aus endoskopischer Sicht gezeigtvollständig zurück bildet [4,6,7,9,14,23,27]. Die Fragmentation der Anastomosenringe war bei allen Tieren am 14. postoperativen Tag begonnen, also ca.…”

Section: Gewebe-hydroxyprolinunclassified

“…Bemerkenswert ist aber, dass in der zervikalen Ösophagusstudie die gleiche Tendenz errechnet wurde. In anderen experimentellen Studien wurden jedoch für die Handnaht-Gruppe ähnliche Werte wie für die BAR-Gruppe bestimmt [4,15] [23]. Aufgrund der eigenen experimentellen Ergebnisse am zervikalen Ösophagus [6,9] und der klinischen Daten von Mokros [19] empfehlen wir jedoch nicht die Anwendung der BAR-Anastomose oberhalb der Trachea-Bifurkation.…”

Section: Experimentelle Medizinunclassified

End-zu-Seit Ösophagojejunostomie mit dem biofragmentierbaren Anastomosenring nach Gastrektomie am Hundemodell

Dietz

Araujo²,

Czeczko³

et al. 2005

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Biofragmentable Anastomosis Ring Versus Stapled Anastomoses in the Extraperitoneal Rectum: Experimental Study in Dogs

Cited by 2 publications

References 10 publications

Overview on Compression Anastomoses: Biofragmentable Anastomosis Ring Multicenter Prospective Trial of 1666 Anastomoses

Overview on Compression Anastomoses: Biofragmentable Anastomosis Ring Multicenter Prospective Trial of 1666 Anastomoses

End-zu-Seit Ösophagojejunostomie mit dem biofragmentierbaren Anastomosenring nach Gastrektomie am Hundemodell

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