BACKGROUND: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans. MATERIALS AND METHODS: This is a prospective study on 25 patients undergoing elective left-sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8-12 weeks after surgery to examine the anastomoses. RESULTS: Fourteen out of 25 patients underwent CARP. CARP was not used in 11 patients due to advanced tumor disease (two cases) and size restrictions (nine cases). No case of anastomotic leakage, bowel obstruction, or stenosis formation was observed. No device-related perioperative adverse events were noted. The surgical device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases. CONCLUSION: Our results indicate that the novel suture-less CARP is a safe and effective method for creating colonic anastomoses. Further studies are warranted in larger patient populations to compare CARP head-on-head with stapled and/or hand-sewn colonic anastomoses.
BACKGROUND: Compression anastomotic ring-locking procedure (CARP) is a novel procedure for creating colonic anastomoses. The surgical procedure allows perioperative quantification of the compression pressure between the intestinal ends within the anastomosis and postoperative monitoring of the anastomotic integrity. We have recently shown that CARP is a safe and effective method for colonic anastomoses in pigs, and the purpose of the present study was to evaluate CARP for colonic anastomoses in humans. MATERIALS AND METHODS: This is a prospective study on 25 patients undergoing elective left-sided colonic resection. Time for evacuation of the anastomotic rings, perioperative compression pressure, and adverse effects were recorded. Postoperative blood samples were collected daily, and flexible sigmoidoscopy was performed 8-12 weeks after surgery to examine the anastomoses. RESULTS: Fourteen out of 25 patients underwent CARP. CARP was not used in 11 patients due to advanced tumor disease (two cases) and size restrictions (nine cases). No case of anastomotic leakage, bowel obstruction, or stenosis formation was observed. No device-related perioperative adverse events were noted. The surgical device evacuated spontaneously in all patients by the natural route after a median of 10 days. Perioperative compression pressure ranged between 85 and 280 mBar (median 130 mBar). Flexible sigmoidoscopy revealed smooth anastomoses without signs of pathological inflammation or stenosis in all cases. CONCLUSION: Our results indicate that the novel suture-less CARP is a safe and effective method for creating colonic anastomoses. Further studies are warranted in larger patient populations to compare CARP head-on-head with stapled and/or hand-sewn colonic anastomoses.
Authors: Magnus S Agren; Thomas L Andersen; Ursula Mirastschijski; Ingvar Syk; Christine Bruun Schiødt; Vikas Surve; Jan Lindebjerg; Jean-Marie Delaissé Journal: Surgery Date: 2006-07 Impact factor: 3.982
Authors: G Galizia; E Lieto; P Castellano; L Pelosio; V Imperatore; F Canfora; C Pignatelli Journal: Int J Colorectal Dis Date: 1999-12 Impact factor: 2.571
Authors: Cristiane B Neutzling; Suzana A S Lustosa; Igor M Proenca; Edina M K da Silva; Delcio Matos Journal: Cochrane Database Syst Rev Date: 2012-02-15
Authors: T Welsch; S A Müller; A Ulrich; A Kischlat; U Hinz; P Kienle; M W Büchler; J Schmidt; B M Schmied Journal: Int J Colorectal Dis Date: 2007-07-17 Impact factor: 2.571
Authors: R Tabola; R Cirocchi; A Fingerhut; A Arezzo; J Randolph; V Grassi; G A Binda; V D'Andrea; I Abraha; G Popivanov; S Di Saverio; A Zbar Journal: Tech Coloproctol Date: 2017-01-28 Impact factor: 3.781
Authors: Jana Steger; Alissa Jell; Stefanie Ficht; Daniel Ostler; Markus Eblenkamp; Petra Mela; Dirk Wilhelm Journal: Ther Clin Risk Manag Date: 2022-05-04 Impact factor: 2.755