title: Thirty-seven patients treated with the C-seal: protection of stapled colorectal anastomoses with a biodegradable sheath.
abstract: OBJECTIVE
  The present study was performed to get a better insight in the incidence of anastomotic leakage leading to reintervention when using the C-seal: a biodegradable sheath that protects the stapled colorectal anastomosis from leakage.
  
  
  METHODS
  The C-seal is a thin walled tube-like sheath that forms a protective sheath within the bowel lumen. Thirty-seven patients undergoing surgery with creation of a stapled colorectal anastomosis with C-seal were analyzed. Follow-up was completed until 3 months after surgery.
  
  
  RESULTS
  One patient (3%) developed anastomotic leakage leading to reintervention. None of the 37 anastomoses was dismantled. One patient was diagnosed with a rectovaginal fistula. In three patients (8%), a perianastomotic abscess spontaneously drained.
  
  
  CONCLUSIONS
  The incidence of anastomotic leakage leading to reintervention when using the C-seal (3%) is lower than expected based on the literature (11%). We have currently set-up a multicenter randomized trial to confirm the efficiency of the C-seal (www.csealtrial.nl).
authors.affiliation: Department of Surgery, Division of Abdominal Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Annelien N
authors.initials: AN
authors.lastname: Morks
authors.forename: Klaas
authors.initials: K
authors.lastname: Havenga
authors.forename: Henk O
authors.initials: HO
authors.lastname: ten Cate Hoedemaker
authors.forename: Jeroen W A
authors.initials: JW
authors.lastname: Leijtens
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: Ploeg
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology; D001672:Biocompatible Materials / Q000494:pharmacology*; D001673:Biodegradation, Environmental; D003106:Colon / Q000601:surgery*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D017792:Surgical Stapling
chemical_list: D001672:Biocompatible Materials