Niti CAR 27 Versus a Conventional End-to-End Anastomosis Stapler in a Laparoscopic Anterior Resection for Sigmoid Colon Cancer.
OBJECTIVE
The Niti CAR 27 (ColonRing) uses compression to create an anastomosis. This study aimed to investigate the safety and the effectiveness of the anastomosis created with the Niti CAR 27 in a laparoscopic anterior resection for sigmoid colon cancer.


METHODS
In a single-center study, 157 consecutive patients who received an operation between March 2010 and December 2011 were retrospectively assessed. The Niti CAR 27 (CAR group, 63 patients) colorectal anastomoses were compared with the conventional double-stapled (CDS group, 94 patients) colorectal anastomoses. Intraoperative, immediate postoperative and 6-month follow-up data were recorded.


RESULTS
There were no statistically significant differences between the two groups in terms of age, gender, tumor location and other clinical characteristics. One patient (1.6%) in the CAR group and 2 patients (2.1%) in the CDS group experienced complications of anastomotic leakage (P = 0.647). These three patients underwent a diverting loop ileostomy. There were 2 cases (2.1%) of bleeding at the anastomosis site in the CDS group. All patients underwent a follow-up colonoscopy (median, 6 months). One patient in the CAR group experienced anastomotic stricture (1.6% vs. 0%; P = 0.401). This complication was solved by using balloon dilatation.


CONCLUSIONS
Anastomosis using the Niti CAR 27 device in a laparoscopic anterior resection for sigmoid colon cancer is safe and feasible. Its use is equivalent to that of the conventional double-stapler.
Department of Surgery, Gyeongsang National University, Postgraduate School of Medicine, Jinju, Korea.
Seung-Jin
SJ
Kwag
Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Jun-Gi
JG
Kim
Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Won-Kyung
WK
Kang
Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Jin-Kwon
JK
Lee
Department of Surgery, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
Seong-Taek
ST
Oh
Anastomotic leak; Colorectal; Compression; Niti