Biofragmentable anastomosis ring in emergency surgery

The biofragmentable anastomosis ring (BAR) proved its usefulness in elective bowel surgery.

To verify the validity of the BAR in restoring bowel continuity in emergency.

The authors retrospectively evaluated the results of 62 intestinal resections and primary anastomoses with the BAR performed in 53 consecutive patients undergoing single-stage surgery for acute abdomen. No patients had either preoperative bowel preparation or intraoperative intestinal lavage.

No proximal ileostomy or colostomy was used. A single anastomosis was made in 47 patients, while the remaining 6 patients underwent multiple intestinal resections with primary anastomoses. Forty-nine of the 53 patients had an uneventful recovery. Anastomotic leakage occurred in 2 patients (3.2%) operated on for an obstructing carcinoma of the left colon. One patient was successfully treated with a period of total parenteral nutrition, whereas the other required reoperation for a complete anastomotic leak due to failed closure of the device which was re-inserted successfully. Two patients (3.7%) died postoperatively of myocardial infarction and hepato-renal syndrome.

Although this is a non-randomised trial, these results suggest that the BAR can be employed effectively in the emergency setting, even when single-stage intestinal surgery is performed.