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

Clinics (Sao Paulo). 2016 May;71(5):264-70. doi: 10.6061/clinics/2016(05)04.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alloys
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / instrumentation*
  • Anastomosis, Surgical / 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

Substances

  • Alloys
  • nitinol