Abstract
The biofragmentable anastomosis ring (BAR) is composed of polyglycolic acid and barium sulfate. When used for intestinal anastomosis, the BAR fragments after the anastomosis is established. We used this device in 43 patients. In three patients, the anastomosis with BAR was abandoned due to technical difficulties. A total of 43 anastomoses with BAR were performed in 40 patients. The operations in which BAR was used included right hemicolectomy in 12 patients, transverse colectomy in 7, sigmoidectomy in 11, small bowel resection in 5 and other bowel resections in 8. The time spent for the BAR anastomsis ranged from 7 to 30 min with a mean of 15.2 min, which was significantly shorter than that of conventional hand-sutured anastomosis in 23 cases. The fragmentation and excretion of the BAR occurred from 14 to 49 days later with a mean of 21.8 days. There was only one instance of anastomotic leakage (1/40, 2.5%), which occurred in a patient with a cytomegaloviral infection of the intestine. A postoperative barium enema study in 28 patients showed no passage disturbance through the anastomosis. In conclusion, the anastomosis using BAR is considered to be a simple, safe, and fast method for performing either colonic or small intestinal anastomosis.
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References
Murphy KB (1892) Cholecysto-intestinal, gastro-intestinal, entero-intestinal anastomosis, and approximation without sutures (original research). Med Record 42(24):665–676
Eigler FW, Gross E (1986) Die maschinelle Kompressionanastmomose (AKA-2) an Colon und Rectum. Chirurg 57:230–235
Hardy TG, Pace WG, Maney JW, Katz AR, Kaganov AL (1985) Biofragmentable ring for sutureless bowel anastomosis: an experimental study. Dis Colon Rectum 28:484–490
Maney JW, Katz AR, Li LK, Pace WG, Hardy TG (1988) Biofragmentable bowel anastomosis ring: Comparative efficacy studies in dogs. Surgery 103:56–62
Hardy TG, Agular PS, Stewart WRC, Katz AR, Maney JW, Costanzo JT, Pace WG (1986) Initial clinical experience with a biofragmentable ring for sutureless bowel anastomosis. Dis Colon Rectum 30:55–61
Hardy TG, Stewart WRC, Aguilar PS, Maney JW, Katz AR, Costanzo JT, Pace WG (1987) Biofragmentable ring for sutureless bowel anastomosis: Early clinical experience. Contemp Surg 31:39–44
Cahill CJ, Betzler M, Gruwez JA, Jeekel J, Pate JC, Zederfeldt B (1989) Sutureless large bowel anastomosis: European experience with the biofragmentable anastomosis ring. Br J Surg 76:344–347
Corman ML, Prager ED, Hardy TG, Rubrick MP (1989) Comparison of the Valtrac biofragmentable anastomosis ring with conventional suture and stapled anastomosis in colon surgery. Dis Colon Rectum 32:183–187
Dyess DL, Curreri PW, Ferrara JJ (1990) A new technique for sutureless intestinal anastomosis. A prospective, randomized, clinical trial. Am Surg 56:71–75
Bubrick MP, Corman ML, Cahill CJ, Hardy TG, Nance FC, Shatney CH (1991) Prospective, randomized trial of the biofragmentable anatomosis ring. Am J Surg 161:136–143
Gullichsen R, Havia T, Ovasaka J, Rantala A (1992) Colonic anastomosis using the biofragmentable anastomotic ring and manual suture: a prospective randomized study. Br J Surg 79:578–580
Forde KA, McLarty AJ, Tsai J, Ghalili K, Delany HM (1993) Murphy's button revisited, clinical experience with the biofragmentable anastomotic ring. Ann Surg 217:78–81
Gullichsen R, Ovaska J, Havia T, Yrjana J, Ekfors T (1993) What happens to the Valtrac anastomosis of the colon. Dis Colon Rectum 36:362–365
Luukkonen P, Jarvinen HJ, Haapianinen R (1990) Early experience with biofragmentable anastomosis ring in colon surgery. Acta Chir Scand 156:795–799
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Konishi, F., Saito, Y., Ugajin, H. et al. Sutureless anastomosis using a biofragmentable anastomosis ring. Surg Today 25, 783–789 (1995). https://doi.org/10.1007/BF00311453
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DOI: https://doi.org/10.1007/BF00311453