Department of Surgery, St. John of God Hospital, Vienna, Johannes von Gott Platz 1, 1020 Vienna, Austria.
World J Surg. 2011 Aug;35(8):1925-32. doi: 10.1007/s00268-011-1135-2.
The ColonRing™ represents a further advancement in compression anastomosis by using superelastic materials. In contrast to other compression devices, its field of application is identical to circular staplers. Yet, limited data are available and there are no reports on the use of this compression device for anastomoses in the lower rectum and in diverted cases.
Between November 2008 and March 2010 a nonrandomized prospective study of patients undergoing colorectal resection was done.
Sixty-two patients (30 female) with a median age of 67 years (range = 23-87) underwent surgery for benign (35) and malignant (27) indications;the surgery was performed laparoscopically in 53 (85.5%) cases. There were no leaks or other major complications related to the compression anastomosis. One patient died from sepsis caused by a leak of a colonic J-pouch. Three of 12 (25%) patients after (ultra-)low anterior resection experienced pain caused by the presence of the ring. Of 53 undiverted patients, rings were passed spontaneously in 52 (98.1%). No spontaneous passage occurred in patients with a stoma. Their rings were removed transanally prior to stoma closure. After a median of 6 months, endoscopic follow-up was performed in 60 patients (96.8%). Two anastomotic stenoses were detected (3.3%).
Construction of rectal anastomosis using this novel compression device is feasible and safe and appears to cause only few anastomotic strictures in the medium term. Discomfort or pain from the presence of the ring at anastomosis following (ultra-)low anterior resection can be observed in a relevant number of patients.
ColonRing™ 代表了使用超弹性材料在压缩吻合方面的进一步发展。与其他压缩装置不同，其应用领域与圆形吻合器相同。然而，可用的数据有限，并且没有关于该压缩装置用于直肠下段吻合和转流病例的报告。
2008 年 11 月至 2010 年 3 月，对接受结直肠切除术的患者进行了一项非随机前瞻性研究。
62 例患者（30 例女性），中位年龄 67 岁（范围=23-87），良性（35 例）和恶性（27 例）指征；53 例（85.5%）手术采用腹腔镜进行。没有与压缩吻合相关的泄漏或其他主要并发症。1 例患者因结肠 J 袋泄漏引起败血症死亡。12 例（超）低位前切除术后的 3 例患者出现吻合环引起的疼痛。53 例未转流的患者中，52 例（98.1%）的吻合环自行排出。造口患者无自行排出。他们的吻合环在造口关闭前经肛门取出。中位随访 6 个月后，对 60 例患者（96.8%）进行了内镜随访。检测到 2 例吻合口狭窄（3.3%）。
使用这种新型压缩装置构建直肠吻合是可行和安全的，并且在中期似乎只导致少数吻合口狭窄。在（超）低位前切除术后，吻合处存在吻合环会引起相当数量的患者不适或疼痛。
