Efficacy and safety of a NiTi CAR 27 compression ring for end-to-end anastomosis compared with conventional staplers: A real-world analysis in Chinese colorectal cancer patients.

Abstract

OBJECTIVES:

This study aimed to evaluate the safety and efficacy of a new nickel-titanium shape memory alloy compression anastomosis ring, NiTi CAR 27, in constructing an anastomosis for colorectal cancer resection compared with conventional staples.

METHODS:

In total, 234 consecutive patients diagnosed with colorectal cancer receiving sigmoidectomy and anterior resection for end-to-end anastomosis from May 2010 to June 2012 were retrospectively analyzed. The postoperative clinical parameters, postoperative complications and 3-year overall survival in 77 patients using a NiTi CAR 27 compression ring (CAR group) and 157 patients with conventional circular staplers (STA group) were compared.

RESULTS:

There were no statistically significant differences between the patients in the two groups in terms of general demographics and tumor features. A clinically apparent anastomotic leak occurred in 2 patients (2.6%) in the CAR group and in 5 patients (3.2%) in the STA group (p=0.804). These eight patients received a temporary diverting ileostomy. One patient (1.3%) in the CAR group was diagnosed with anastomotic stricture through an electronic colonoscopy after 3 months postoperatively. The incidence of postoperative intestinal obstruction was comparable between the two groups (p=0.192). With a median follow-up duration of 39.6 months, the 3-year overall survival rate was 83.1% in the CAR group and 89.0% in the STA group (p=0.152).

CONCLUSIONS:

NiTi CAR 27 is safe and effective for colorectal end-to-end anastomosis. Its use is equivalent to that of the conventional circular staplers. This study suggests that NiTi CAR 27 may be a beneficial alternative in colorectal anastomosis in Chinese colorectal cancer patients.

• Authors: Zhenhai Lu, Jianhong Peng, Cong Li, Fulong Wang, Wu Jiang, Wenhua Fan, Junzhong Lin, Xiaojun Wu, Desen Wan, Zhizhong Pan
• Journal: Clinics (Sao Paulo, Brazil) (Clinics (Sao Paulo)) Vol. 71 Issue 5 Pg. 264-70 (May 2016) ISSN: 1980-5322 [Electronic] United States
• PMID: 27276395 (Publication Type: Journal Article)

Chemical References

• Alloys
• nitinol

Topics

• Adult
• Aged
• Aged, 80 and over
• Alloys
• Anastomosis, Surgical (adverse effects, instrumentation, methods)
• Anastomotic Leak (etiology)
• Colon, Sigmoid (surgery)
• Colorectal Neoplasms (surgery)
• Equipment Design
• Equipment Safety (instrumentation)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Period
• Retrospective Studies
• Surgical Staplers (adverse effects)
• Treatment Outcome
• Young Adult