[The indications for the Valtrac-ring--Report on 1015 Anastomoses]

Area of Science:

• Gastrointestinal Surgery
• Surgical Devices
• Clinical Outcomes

Background:

• The Valtrac anastomosis device has been utilized in various gastrointestinal surgical procedures.
• Evaluating the efficacy and safety of surgical anastomosis techniques is crucial for patient outcomes.

Purpose of the Study:

• To assess the anastomosis insufficiency rate of the Valtrac device in a large patient cohort.
• To identify specific gastrointestinal tract locations where Valtrac anastomosis is most effective and where it may be less indicated.

Main Methods:

• Prospective data collection of 1,015 Valtrac-anastomoses performed in 876 patients over a 10-year period (June 1991-June 2000).
• Analysis of patient demographics, disease types (malignant vs. benign), and anastomosis insufficiency rates.
• Stratification of insufficiency rates based on the location within the upper and lower gastrointestinal tract.

Main Results:

• An overall anastomosis insufficiency rate of 1.1% per anastomosis and 1.3% per patient was observed.
• A significant difference in insufficiency rates was found between the upper gastrointestinal tract (0.4%) and the lower gastrointestinal tract (4.2%).
• The Valtrac device showed promise in specific applications including intrathoracic oesophagogastrostomy, gastrostomy for pyloric stenosis, and small bowel Y-Roux reconstructions.

Conclusions:

• The Valtrac anastomosis device is associated with a low insufficiency rate, particularly in the upper gastrointestinal tract.
• Routine use of Valtrac anastomosis is not recommended for oesophagojejunostomy after gastrectomy or colorectal anastomosis after rectum resection due to higher insufficiency rates.
• Valtrac is recommended for specific indications such as intrathoracic oesophagogastrostomy, gastrostomy, and small bowel reconstruction.