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Updated: Jun 28, 2025

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
Published on: November 4, 2010
Does Tri-Staple™ technology reduce the risk of anastomotic leakage in colorectal surgery? A propensity score matching
Lucas Soares Gerbasi1, Francisco Tustumi1, Victor Edmond Seid1
1Department of Health Sciences, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Background And Objectives:
This study evaluates the Tri-Staple™ technology in colorectal anastomosis.
Methods:
Patients who underwent rectosigmoidectomy between 2016 and 2022 were retrospectively evaluated and divided into two groups: EEA™ (EEA) or Tri-Staple™ (Tri-EEA). The groups were matched for age, sex, American Society of Anesthesiologists (ASA), and neoadjuvant radiotherapy using propensity score matching (PSM).
Result:
Three hundred and thirty-six patients were included (228 EEA; 108 Tri-EEA). The groups were similar in sex, age, and neoadjuvant therapy. The Tri-EEA group had fewer patients with ASA III/IV scores (7% vs. 33%; p < 0.001). The Tri-EEA group had a lower incidence of leakage (4% vs. 11%; p = 0.023), reoperations (4% vs. 12%; p = 0.016), and severe complications (6% vs. 14%; p = 0.026). There was no difference in complications, mortality, readmission, and length of stay. After PSM, 108 patients in the EEA group were compared with 108 in the Tri-EEA group. The covariates sex, age, neoadjuvant radiotherapy, and ASA were balanced, and the risk of leakage (4% vs. 12%; p = 0.04), reoperation (4% vs. 14%; p = 0.014), and severe complications (6% vs. 15%; p = 0.041) remained lower in the Tri-EEA group.
Conclusion:
Tri-Staple™ reduces the risk of leakage in colorectal anastomosis. However, this study provides only insights, and further research is warranted to confirm these findings.

