SUTURELESS ANASTOMOSIS USING A BIOFRAGMENTABLE ANASTOMOSIS RING

The biofragmentable anastomosis ring (BAR) is composed of polyglycolic acid and barium sulfate. When used for intestinal anastomosis, the BA R fragments after the anastomosis is established. We used this device in 43 patients. In three patients, the anastomosis with BAR was abando ned due to technical difficulties. A total of 43 anastomoses with BAR were performed in 40 patients. The operations in which BAR was used in cluded right hemicolectomy in 12 patients, transverse colectomy in 7, sigmoidectomy in 11, small bowel resection in 5 and other bowel resect ions in 8. The time spent for the BAR anastomsis ranged from 7 to 30 m in with a mean of 15.2 min, which was significantly shorter than that of conventional hand-sutured anastomosis in 23 cases. The fragmentatio n and excretion of the BAR occurred from 14 to 49 days later with a me an of 21.8 days. There was only one instance of anastomotic leakage (1 /40, 2.5%), which occurred in a patient with a cytomegaloviral infecti on 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 fas t method for performing either colonic or small intestinal anastomosis .