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

Background and aims. Colorectal cancer is one of the most frequent digestive malignancies, being the third cause of death by cancer, despite early diagnosis and therapeutic progress made over the past years. Standard treatment in these patients is to preserve the anal sphincter with restoration of intestinal function by mechanical colorectal anastomosis or coloanal anastomosis, and to maintain genitourinary function by preservation of hypogastric nerves.Methods. In order to emphasize the importance of this surgical technique in the Fourth Surgical Clinic of the CF Clinical Hospital Cluj-Napoca, we conducted a prospective observational interventional study over a 3-year period (2013-2016) in 165 patients hospitalized for rectal and rectosigmoid adenocarcinoma in various disease stages, who underwent Dixon surgery using the two techniques of manual and mechanical end-to-end anastomosis. For mechanical anastomosis, we used Covidien and Panther circular staplers. The patients were assigned to two groups, group A in which Dixon surgery with manual end-to-end anastomosis was performed (116 patients), and group B in which Dixon surgery with mechanical end-to-end anastomosis was carried out (49 patients).Results. Mechanical anastomosis allowed to restore intestinal continuity following low anterior resection in 21 patients with lower rectal adenocarcinoma compared to 2 patients in whom intestinal continuity was restored by manual anastomosis, with a statistically significant difference (p<0.000001). The double-row mechanical suture technique is associated with a reduced duration of surgery (121.67 minutes for Dixon surgery with mechanical anastomosis, compared to 165.931 minutes for Dixon surgery with manual anastomosis, p<0.0001).Conclusion. The use of circular transanal staplers facilitates end-to-end anastomosis by double-row mechanical suture, allowing to perform low anterior resection in situations when the restoration of intestinal continuity by manual anastomosis is technically not possible, with the aim to preserve the anal sphincter, to restore intestinal function and maintain genitourinary function through preservation of hypogastric nerves.

Download Full-text

NiTi Shape Memory Compression Anastomosis Clip in Small- and Large-Bowel Anastomoses

Surgical Innovation ◽

10.1177/1553350612474494 ◽

2013 ◽

Vol 20 (6) ◽

pp. 580-585 ◽

Cited By ~ 3

Author(s):

Katarzyna Kusnierz ◽

Henryk Morawiec ◽

Zbigniew Lekston ◽

Dmytro Zhavoronkov ◽

Magdalena Lucyga ◽

...

Keyword(s):

Shape Memory ◽

Large Bowel ◽

Memory Compression ◽

Compression Anastomosis

Download Full-text

Side-to-end vs. Colonic Pouch vs. End-to-end Anastomosis in Low Anterior Resection

The Showa University Journal of Medical Sciences ◽

10.15369/sujms1989.20.61 ◽

2008 ◽

Vol 20 (2) ◽

pp. 61-68

Author(s):

Akira TSUNODA ◽

Goichi KAMIYAMA ◽

Naoto SUZUKI ◽

Makoto WATANABE ◽

Kazuhiro NARITA ◽

...

Keyword(s):

Anterior Resection ◽

Low Anterior Resection ◽

Colonic Pouch ◽

End To End

Download Full-text

The use of shape memory compression anastomosis clips in cholecystojejunostomy in pigs – a preliminary study

Acta Veterinaria Brno ◽

10.2754/avb201584040403 ◽

2015 ◽

Vol 84 (4) ◽

pp. 403-406

Author(s):

Piotr Holak ◽

Marek Jalynski ◽

Zdzisław Lekston ◽

Izabella Babinska ◽

Zbigniew Adamiak

Keyword(s):

Animal Model ◽

Titanium Alloy ◽

Shape Memory ◽

Nickel Titanium ◽

Anastomotic Site ◽

Memory Compression ◽

Compression Anastomosis ◽

Surgical Tool ◽

Preliminary Study ◽

Positive Results

This paper reports on the use of compression anastomosis clips (CAC) in cholecystoenterostomy in an animal model. Cholecystojejunostomy was performed in 6 pigs using implants made of nickel-titanium alloy in the form of elliptical springs with two-way shape memory. The applied procedure led to the achievement of tight anastomosis with a minimal number of complications and positive results of histopathological evaluations of the anastomotic site. The results of the study indicate that shape memory NiTi clips are a promising surgical tool for cholecystoenterostomy in cats and dogs.

Download Full-text

Anastomotic leakage after low anterior resection for rectal cancer: comparison of stapled versus compression anastomosis

Langenbeck s Archives of Surgery ◽

10.1007/s00423-013-1103-4 ◽

2013 ◽

Vol 398 (7) ◽

pp. 957-964 ◽

Cited By ~ 11

Author(s):

Bernhard Dauser ◽

Tamara Braunschmid ◽

Shahbaz Ghaffari ◽

Stefan Riss ◽

Anton Stift ◽

...

Keyword(s):

Rectal Cancer ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Low Anterior Resection ◽

Compression Anastomosis

Download Full-text

Low anterior resection using compression anastomosis apparatus AKA-2.

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.40.850 ◽

1987 ◽

Vol 40 (7) ◽

pp. 850-854

Author(s):

T. Takahashi ◽

S. Ohki ◽

Y. Ohmi ◽

A. Iida ◽

K. Furushima ◽

...

Keyword(s):

Anterior Resection ◽

Low Anterior Resection ◽

Compression Anastomosis

Download Full-text

End-to-end versus end-to-side anastomosis for low anterior resection: A systematic review and meta-analysis of randomized controlled trials

Surgery ◽

10.1016/j.surg.2020.12.030 ◽

2021 ◽

Author(s):

Tyler McKechnie ◽

Sahil Sharma ◽

Ryan Daniel ◽

Cagla Eskicioglu

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Anterior Resection ◽

Low Anterior Resection ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

End To End

Download Full-text

Effectiveness of gastroduodenostomy created with the use of shape memory compression anastomosis clips: observations in a porcine model

Veterinární Medicína ◽

10.17221/22/2017-vetmed ◽

2018 ◽

Vol 63 (No. 1) ◽

pp. 12-17

Author(s):

P. Holak ◽

M. Jalynski ◽

I. Babinska

Keyword(s):

Postoperative Complications ◽

Shape Memory ◽

Surgical Outcomes ◽

Surgical Procedure ◽

Porcine Model ◽

Low Cost ◽

Memory Compression ◽

Compression Anastomosis

This article evaluates the effectiveness of gastroduodenostomies created with the use of shape memory compression anastomosis clips (CAC) and compares the surgical outcomes with those of hand-sewn anastomoses. We performed Billroth’s operation I in eight pigs: shape memory compression clips were used in six animals and hand-sewn anastomoses were created in two animals. Postoperative complications such as leakage or obstructed passage of digesta were not observed in any of the patients. Pathomorphological examinations and histopathological analyses confirmed that all anastomoses were tight and that gastroduodenal continuity was fully restored. In comparison with hand-sewn anastomoses, compression clips shortened the time of the surgical procedure and proved to be a safe, effective and low-cost technique for performing Billroth’s operation I in animals. The experience and knowledge acquired during the experiment will be used to maximise the effectiveness of gastroduodenostomy in canine and feline patients.

Download Full-text

Rectal Reconstruction after Total Mesorectumectomy: Functional Outcomes and Quality of Life

Creative Surgery and Oncology ◽

10.24060/2076-3093-2021-11-3-195-202 ◽

2021 ◽

Vol 11 (3) ◽

pp. 195-202

Author(s):

A. O. Rasulov ◽

A. B. Baychorov ◽

A. M. Merzlyakova ◽

A. I. Ovchinnikova ◽

A. V. Semyanikhina

Keyword(s):

Quality Of Life ◽

Anterior Resection ◽

Functional Outcomes ◽

Low Anterior Resection ◽

Low Anterior Resection Syndrome ◽

Anterior Resection Syndrome ◽

Post Surgery ◽

J Pouch ◽

End To End

Background. The study aims to compare the functional outcomes and quality of life in patients having variant rectal reconstruction procedures after low anterior resection for cancer.Materials and methods. A prospective randomised controlled trial enrolled 90 patients who underwent total mesorectumectomy with formation of J-pouch (J-P), side-to-end (STE) or end-to-end (ETE) anastomoses.Results and discussion. We analysed 22 J-P, 30 STE and 38 ETE patients. For technical reasons, 26.6 % J-Ps were remodelled to other anastomoses. The neorectal sensory threshold, first and permanent defecation urges and maximal tolerated volume were higher in J-P at months 3–6–12 postoperatively.Severe low anterior resection syndrome events at post-surgery month 6 were significantly more frequent in the ETE vs. J-P and STE cohorts (21, 0 and 3.3 %, respectively, p < 0.05). Stool frequency was significantly lower in J-P vs. STE and ETE at months 3–6–12. Wexner score was 3, 5, 6 at month 6 (p < 0.05) and 0, 1, 1 at month 12 for J-P, STE and ETE, respectively (p > 0.05). Evacuatory dysfunction was present at month 6 in 59.1 J-P, 33.3 STE and 21.1 % ETE.Quality of life (FIQL) in J-P and STE was significantly higher vs. ETE anastomoses in the Lifestyle (3.21, 3.22 and 3.03, respectively, p < 0.05) and Coping (3.29, 3.21 and 2.95, respectively, p < 0.05) scales to month 12 postoperatively.Conclusion. The J-pouch formation after low anterior resection ameliorates anal continence at months 3–6 post-surgery, reduces low anterior resection syndrome and improves quality of life (FIQL). The ease of implementation and irrelevance of evacuatory dysfunction in side-to-end anastomosis make it a superior choice over end-to-end surgery.

Download Full-text