Sutureless compression anastomosis with a biofragmentable anastomosis ring

Area of Science:

• Colorectal Surgery
• Surgical Devices
• Anastomosis Techniques

Background:

• Biofragmentable anastomotic rings (BARs) are reported safe and effective.
• BARs are not widely adopted, particularly in Japan.
• Clinical benefits and reasons for BAR unpopularity require investigation.

Purpose of the Study:

• To evaluate the clinical benefits of BARs.
• To identify reasons for the limited use of BARs in Japan.
• To compare BARs with end-to-end (EEA) staplers in sigmoidectomy and high anterior resection (HAR).

Main Methods:

• Retrospective study of 61 patients undergoing sigmoidectomy or HAR.
• Patients divided into four groups based on procedure and anastomosis method (BAR vs. EEA stapler).
• Comparison of anastomosis time, stricture formation, and hospitalization duration.

Main Results:

• Anastomosis time was significantly shorter with EEA staplers in HAR (HARE group) compared to BARs (HARB group).
• Anastomotic stricture incidence was lower in the BAR group (HARB) compared to the EEA stapler group (HARE).
• Hospitalization duration was longer in the BAR group (HARB) than in the EEA stapler group (HARE).

Conclusions:

• BARs are less popular due to delayed device passage and handling difficulties in narrow pelvic spaces compared to staplers.
• Staplers are easier to manipulate in confined pelvic anatomy.
• The choice between BARs and staplers involves balancing stricture risk, operative time, and hospital stay.