Utilizzazione clinica di una nuova suturatrice meccanica a compressione in chirurgia del grosso intestino

The clinical experience with the use in colorectal surgery of a new compression anastomotic device developed by the Authors is reported. From May 1986 through June 1990, 95 patients underwent large bowel anastomosis using this device. Operations performed included 51 left hemicolectomies or anterior resections of the sigmoid and rectum, 23 left colon resections, 19 right hemicolectomies, and two total colectomies. Twenty-nine anastomoses were performed below the pelvic peritoneal reflection and 18.5% of them resulted less than 4 cms from the anal verge while 20% were located between 4.5 and 8 cms. Five (5.2%) intraoperative diverting colostomies were needed. The rings were evacuated postoperatively after a mean of 10.9 days with none or very little discomfort. Operative mortality was 1.0% (one patient died of myocardial infarction). Anastomotic complications included five (5.2%) clinical and four (4.2%) subclinical leakages. No haemorrhages or stenoses were observed. This initial clinical experience shows the anastomotic device is reliable and justifies further experimentation.