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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 April;12(2):159-64
Use of BAR (Biofragmentable Anastomotic Ring) Valtrac® system in gastrointestinal surgery
Allegri C., Mariotti V., Spoletini F., Morucci P., Mustacciuoli G., Montalto G., Vari A., Polinari U.
Background. The use of BAR (Biofragmentable Anastomotic Ring) Valtrac® (Davis Geck, Wayne NJ, USA) for anastomoses in the gastrointestinal tract surgery is described. The BAR device is made of two identical shell-shaped segments made of biofragmentable materials (polyglycolic acid and barium sulphate) that are easily purse-string sutured to the lumen and then snapped shut. A gap between the two segments is designed to avoid necrosis at the site of approximation. The BAR is available in various diameters (25, 28, 31 and 34 mm) and gap sizes (1,5, 2 and 2,5 mm).
Methods. Personal experience in 166 patients treated from 1/1/1991 to 30/4/1995 is reported and described: sex (female: 63; male: 53), age (mean: 65.2), type of disease (left colon cancer: 27; right colon cancer: 29; diverticular stenosis of the sigmoid: 12; transverse colon cancer: 5; Crohn's disease: 3; post-radiation stenosis of the sigmoid: 1; multiple polyposis: 1; gastric cancer: 24; pancreatic cancer: 3; intestinal infarction: 7; obesity: 5; duodenal cancer: 1 and site of the anastomosis (upper G.I. tract: n. 40; lower G.I. tract: n. 78).
Results. Postoperative mortality reported is 0.8%. Minor complications included two cases of intestinal sub-obstruction (1.6%) resolved with medical therapy. Average return to bowel function was generally on 3rd-6th postop. day; the BAR fragments were expelled on 15th-20th postop day.
Conclusions. According to the latest reported data, the conclusion is drawn that the BAR is a safe and effective instrument for performing an intestinal anastomosis (optimal diameter, good distensibility, absence of granulomas), and that the only limit of this device is the prolonged liquid diet and TPN required in upper G.I. tract anastomoses.