Long-Term Results after 75 Anastomoses in the Upper Extraperitoneal Rectum with the Biofragmentable Anastomosis Ring

Abstract

Background: Anastomoses in the rectum have a higher risk for complications compared with other gastrointestinal regions. Stapling devices and sophisticated developments in surgical suture materials did not lead to a substantial decrease of local complications. The bioabsorbable anastomosis ring (BAR) is a new alternative technique for creating gastrointestinal anastomoses. Accordingly, the aim of this prospective study was to evaluate the postoperative course and long-term results of patients after anterior rectum resection using BAR. Methods: From 1991 to 1996 75 BAR anastomoses were performed in the upper rectum at the Department of Surgery, University Hospital Würzburg. Thirty-eight patients suffered from malignant, 37 from benign disease. Mean age was 61.4 years with no relevant differences in the gender. Mean follow-up was 31 months (4–63 months). The clinical course was evaluated, a questionnaire completed and/or a 3-monthly reevaluation with endoscopy conducted. Mortality, anastomostic bleeding, leakage and development of anastomotic stenosis were evaluated. Results: Sixty-seven patients could be reexamined. There was no postoperative mortality and no anastomotic bleeding. Six patients (8%) developed an anastomotic leakage, of whom 3 (4%) required reoperation. None of the patients revealed a detectable stenosis in the anastomotic region during follow-up. Conclusion: The BAR procedure is a safe and suitable anastomotic technique after anterior rectum resection.

Safety and Efficacy of the NiTi Shape Memory Compression Anastomosis Ring (CAR/ColonRing) for End-to-End Compression Anastomosis in Anterior Resection or Low Anterior Resection

“…13 Similarly, longterm results with the biofragmentable anastomosis ring also suggested low postoperative stenosis rates. 14 Recently, a technological advance has been made that incorporates a nickel-titanium (Nitinol) shape memory alloy leaf-spring into a 27-mm anastomotic device (ColonRing, NiTi Medical Technologies Ltd, Netanya, Israel). 15,16 The compression anastomosis ring (ColonRing) may prove to be a potential alternative in achieving a foreign-body-free anastomosis.…”